Individual provider Active NPI

Tiffany Danielle Holt

  • Family Nurse Practitioner
  • Pearisburg, VA
National Provider Identifier
1104488626
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024187638 Issued in VA
Practice address
430 Boxwood LN
Pearisburg, VA 24134-1168
Phone
(540) 921-6110
Fax
(540) 921-3796
NPI assigned
Jul 4, 2019
Last updated
Jul 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26026 TN
Family Nurse Practitioner 363LF0000X 0024187638 VA Primary

Addresses

Primary practice location

430 Boxwood LN
Pearisburg, VA 24134-1168

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713

Other practice location 1

3601 The Vanderbilt Clinic
Nashville, TN 37232-6503
Phone (615) 322-3000

Other practice location 2

1276 Gilbreath Dr
Johnson City, TN 37614-6503
Phone (423) 439-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tholt499172@direct.vumc.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230815002657 VA Practitioner - Nurse Practitioner 9032525381 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Giles Community HospitalGroup PAC ID 3678670221, 223 clinicians

Practice addresses (Care Compare)

159 Hartley Way
Pearisburg, VA 24134-2471
Phone (540) 921-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26026TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Giles Community Hospital CurrentSince Aug 28, 2023 Accepting new patients
Carilion Giles Community Hospital CurrentSince Aug 28, 2023 Accepting new patients

Locations

159 Hartley Way
Pearisburg, VA 24134
Phone (540) 921-6000

430 Boxwood Ln
Pearisburg, VA 24134
Phone (540) 921-3636

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

Interoperability endpoints

  • Direct secure messaging: tholt169263@direct.carilionclinic.org
  • Direct secure messaging: tholt499172@direct.vumc.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1104488626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 BOXWOOD LN",
            "city": "PEARISBURG",
            "state": "VA",
            "postal_code": "241341168",
            "telephone_number": "540-921-6110",
            "fax_number": "540-921-3796"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 The Vanderbilt Clinic",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372326503",
            "country_code": "US",
            "telephone_number": "615-322-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1276 Gilbreath Dr",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376146503",
            "country_code": "US",
            "telephone_number": "423-439-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLT",
        "first_name": "TIFFANY",
        "middle_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-04",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "26026",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024187638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tholt499172@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "3601 The Vanderbilt Clinic",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372326503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pearisburg, VA

Sources for this page

Verify at the official NPI Registry.