Ken V Holt, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

13534A Issued in WY

Practice address

125 Wyoming St
Lander, WY 82520-3919

Phone

(307) 206-1330

Fax

(307) 206-1331

NPI assigned

Mar 8, 2006

Last updated

May 17, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Kenny V Holt Other name

Medicare fee-for-service enrollment

Enrolled in MO, WY, AR, AK4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 4

Specialty

Obstetrics/GynecologyAlso: Family Practice

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Hospital of Sweetwater CountyGroup PAC ID 0244124550, 70 clinicians

Lake Regional Health SystemGroup PAC ID 9133026776, shared by 16 NPIs, 132 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital Sweetwater County Hospital, Rock Springs, WY, CCN 531318
• Lake Regional Health System Hospital, Osage Beach, MO, CCN 260186

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ken.holt@bhcawp.eclinicaldirectplus.com

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.

• Memorial Hospital of Sweetwater County

  dba County of Sweetwater

  • Critical Access Hospital
  • Rock Springs, WY
  • NPI 1558361949
  Medicare reassignment Care Compare group NPD
• Baxter County Regional Hospital Inc

  dba D/B/a Baxter Regional Pulmonology Clinic

  • Pulmonary Disease Physician
  • Mountain Home, AR
  • NPI 1447420997
  Medicare reassignment NPD
• Golden Valley Memorial Hospital District

  dba Golden Valley Medical - Clinton

  • Rural Health Clinic/Center
  • Clinton, MO
  • NPI 1003873266
  Medicare reassignment NPD
• Mat-Su Valley III LLC

  • Internal Medicine Physician
  • Palmer, AK
  • NPI 1366752560

  Obstetrics & Gynecology

  Medicare reassignment NPD
• West Park Hospital District

  dba Cody Regional Health

  • Critical Access Hospital
  • Cody, WY
  • NPI 1558351536
  Medicare reassignment
• Lake Regional Health System

  • Emergency Medical Services (Emergency Medicine) Physician
  • Osage Beach, MO
  • NPI 1053581454
  Medicare reassignment
• Aspenglow Obstetrics and Gynecology, LLC

  • Obstetrics & Gynecology Physician
  • Lander, WY
  • NPI 1710644307
  Authorized official Same address or phone
• Baxter County Regional Hospital Inc

  dba Baxter Health Comprehensive Women's Clinic

  • Clinic/Center
  • Mountain Home, AR
  • NPI 1598030579
  NPD
• Baxter County Regional Hospital, Inc

  dba Baxter Health College Street Family Clinic

  • Family Medicine Physician
  • Mountain Home, AR
  • NPI 1316777329
  NPD
• Golden Valley Memorial Hospital District

  dba GVMH Medical East

  • Clinic/Center
  • Clinton, MO
  • NPI 1396379830
  NPD
• Golden Valley Memorial Hospital District

  • General Acute Care Hospital
  • Clinton, MO
  • NPI 1710075361
  NPD
• Mat-Su Valley III LLC

  dba Mat Su Urgent Care - Palmer

  • Urgent Care Clinic/Center
  • Palmer, AK
  • NPI 1518472984
  NPD

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

• Memorial Hospital of Sweetwater County

  dba County of Sweetwater

  • Critical Access Hospital
  • Rock Springs, WY
  • NPI 1558361949
  Care Compare affiliation
• Lake Regional Health System

  • Clinic/Center
  • Osage Beach, MO
  • NPI 1295151959

  Hospital

  Care Compare affiliation
• Lake Regional Health System

  • Rural Acute Care Hospital
  • Osage Beach, MO
  • NPI 1386619450
  Care Compare affiliation

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1104894047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 WYOMING ST",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825203919",
            "telephone_number": "307-206-1330",
            "fax_number": "307-206-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 WYOMING ST",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825203919",
            "telephone_number": "307-206-1330",
            "fax_number": "307-206-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "KEN",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2005020340",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WY",
            "license": "13534A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENNY",
            "last_name": "HOLT",
            "middle_name": "V",
            "prefix": "DR.",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Obstetrics & Gynecology Physician in Lander, WY
• Providers in Lander, WY by specialty
• Obstetrics & Gynecology Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.