Individual provider Active NPI

Leanne Michelle Holmes, FNP-C

  • Family Nurse Practitioner
  • Poplar Bluff, MO
National Provider Identifier
1124566104
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2017003066 Issued in MO
Practice address
2651 Shelby Rd
Poplar Bluff, MO 63901-2387
Phone
(573) 843-8380
Fax
(573) 843-8381
NPI assigned
Feb 9, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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 2017003066 MO Primary

Addresses

Primary practice location

2651 Shelby Rd
Poplar Bluff, MO 63901-2387

Mailing address

2651 Shelby Rd
Poplar Bluff, MO 63901-2387
Phone (573) 843-8380

Other practice location 1

#1 Hal's Plaza Drive
Piedmont, MO 63957
Phone (573) 223-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20170412000126 MO Practitioner - Nurse Practitioner 6103102876 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017003066MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Perry Current Accepting new patients
St Louis Medical Associates LLC CurrentSince Feb 4, 2024 Accepting new patients
Community Urgent Care LLC CurrentSince Nov 3, 2024 Accepting new patients
Mercy Hospital Perry CurrentSince Mar 3, 2025 Accepting new patients
Big Springs Medical Association CurrentSince Jan 1, 2020 Accepting new patients
Big Springs Medical Association Current Accepting new patients
Big Springs Medical Association CurrentSince Jan 1, 2020 Accepting new patients
Southeast Missouri Hospital Physicians, LLC CurrentSince May 10, 2023 Accepting new patients

Locations

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

624 Old St Marys Rd
Ste A
Perryville, MO 63775
Phone (573) 547-3232

434 N West St
Perryville, MO 63775
Phone (573) 547-2530

1 Hals Plz
Piedmont, MO 63957
Phone (573) 223-4800

2651 Shelby Rd
Poplar Bluff, MO 63901
Phone (573) 843-8380

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1124566104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2651 SHELBY RD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012387",
            "telephone_number": "573-843-8380",
            "fax_number": "573-843-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 SHELBY RD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012387",
            "telephone_number": "573-843-8380",
            "fax_number": "573-843-8381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "#1 Hal's Plaza Drive",
            "address_purpose": "LOCATION",
            "city": "Piedmont",
            "state": "MO",
            "postal_code": "63957",
            "country_code": "US",
            "telephone_number": "573-223-4800",
            "fax_number": "573-223-2762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "LEANNE",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-09",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017003066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

Verify at the official NPI Registry.