Active NPI
Y'Vonda Darlene Holmes, APRN, FNP, CNP
- Family Nurse Practitioner
- Rolla, MO
National Provider Identifier
1073883369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2011026455
- Practice address
- 1605 Martin Springs Dr
Rolla, MO 65401-2982 - Phone
- (573) 458-6326
- NPI assigned
- Jan 4, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2011026455 | MO | Primary |
Addresses
Primary practice location
1605 Martin Springs Dr
Rolla, MO 65401-2982
Mailing address
PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 431560263 | Other | MO | TRICARE |
| 080020472 | Other | MO | RR MCR |
| 1073883369 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384905600000",
"number": "1073883369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2580",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658012580",
"telephone_number": "417-829-4620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1605 MARTIN SPRINGS DR",
"city": "ROLLA",
"state": "MO",
"postal_code": "654012982",
"telephone_number": "573-458-6326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMES",
"first_name": "Y'VONDA",
"middle_name": "DARLENE",
"name_prefix": "Ms.",
"credential": "APRN, FNP, CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-04",
"last_updated": "2013-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MO",
"license": "2011026455",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "431560263",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MCR",
"identifier": "080020472",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1073883369",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rolla, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.