Individual provider Active NPI

Gwyneth Leigh Holderby, DNP

  • Family Nurse Practitioner
  • Alva, OK
National Provider Identifier
1124447305
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
96130 Issued in OK
Practice address
709 Oklahoma Blvd
Alva, OK 73717-2749
Phone
(580) 327-8434
NPI assigned
Apr 15, 2014
Last updated
Jul 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 96130 OK Primary

Addresses

Primary practice location

709 Oklahoma Blvd
Alva, OK 73717-2749

Mailing address

709 Oklahoma Blvd
Alva, OK 73717-2749

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20141111000368 OK Practitioner - Nurse Practitioner 3173745932 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alva Hospital AuthorityGroup PAC ID 5597755306, 14 clinicians

Practice addresses (Care Compare)

800 Share Dr
Alva, OK 73717-3618
Phone (580) 430-3366

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
64.87 of 100Reported as group
Quality
33.38
Promoting interoperability
79
Improvement activities
40
Cost
67.03

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
96130OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alva Hospital Authority/Dba Share Medical Center CurrentSince Jul 1, 2014 Accepting new patients
Enhanced Wound Care LLC CurrentSince May 19, 2023 Accepting new patients
Alva Hospital Authority CurrentSince Jul 1, 2014 Accepting new patients
Alva Hospital Authority Current Accepting new patients
Alva Hospital Authority Past Accepting new patients
Summit Medical Center Past Accepting new patients
Alva Hospital Authority Past Accepting new patients

Locations

410 4th St
Ste J
Alva, OK 73717
Phone (580) 430-3333

800 Share Dr
Alva, OK 73717
Phone (580) 327-2800

6440 Avondale Dr
Ste 20035
Nichols Hills, OK 73116
Phone (918) 231-8724

Organizations & group practices 7

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 2

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": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1124447305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 OKLAHOMA BLVD",
            "city": "ALVA",
            "state": "OK",
            "postal_code": "737172749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 OKLAHOMA BLVD",
            "city": "ALVA",
            "state": "OK",
            "postal_code": "737172749",
            "telephone_number": "580-327-8434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDERBY",
        "first_name": "GWYNETH",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "96130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alva, OK

Sources for this page

Verify at the official NPI Registry.