Edris Y Holland, RN MSN FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95017058 Issued in CA

Practice address

520 W Palmdale Blvd
Palmdale, CA 93551-4229

Phone

(661) 947-3300

Fax

(661) 947-3322

NPI assigned

Oct 9, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Palmdale Medical Clinic IncGroup PAC ID 2264703743, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tribute Home Health Care, Inc. Home health agency, Glendale, CA, CCN 757415
• Blue Sky Home Health, Inc Home health agency, Mission Hills, CA, CCN 058475

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

Locations

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.

• Palmdale Medical Clinic Inc

  • Family Medicine Physician
  • Palmdale, CA
  • NPI 1851849863

  CA

  Medicare reassignment Care Compare group NPD

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

• Blue Sky Home Health, Inc.

  • Home Health Agency
  • Mission Hills, CA
  • NPI 1962540567
  Care Compare affiliation
• Tribute Home Health Care, Inc.

  • Home Health Agency
  • Glendale, CA
  • NPI 1518537414
  Care Compare affiliation

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618099200000",
    "number": "1154929495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41405 SEQUOIA AVE",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935511912",
            "telephone_number": "310-672-4581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 W PALMDALE BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935514229",
            "telephone_number": "661-947-3300",
            "fax_number": "661-947-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "EDRIS",
        "middle_name": "Y",
        "credential": "RN MSN FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-09",
        "last_updated": "2021-04-11",
        "certification_date": "2021-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "374283",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "374283",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FNP-C LICENSE NUMBER",
            "identifier": "95017058",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roxanne Spencer Hobbs, FNP
• Michelle Lynn Hoeltgen, SLP
• Kifera Sivan Hoffman
• Leigh Holahan, DPT
• Robin Holden, LCSW
• Zany'a Holland
• Dawn Hollins
• Breshiana Holmes
• Chelsey Rene Holzer
• Honest Healing Therapeutic Services, Corporation

• All providers in Palmdale, CA
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2021; 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.