Individual provider Active NPI

Brandy N Holder

  • Family Nurse Practitioner
  • Greeneville, TN
National Provider Identifier
1174153357
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
27055 Issued in TN
Practice address
1404 Tusculum Blvd Ste 3100
Greeneville, TN 37745-4648
Phone
(423) 638-4114
NPI assigned
Jan 16, 2020
Last updated
Jul 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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 27055 TN Primary

Addresses

Primary practice location

1404 Tusculum Blvd Ste 3100
Greeneville, TN 37745-4648

Mailing address

1275 Dick Lonas Rd
Knoxville, TN 37909-1382
Phone (865) 584-4747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20200604002079 TN Practitioner - Nurse Practitioner 2466873146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group, PLLCGroup PAC ID 2860396330, 636 clinicians

Practice addresses (Care Compare)

555 Justis Dr
Greeneville, TN 37745-4288
Phone (423) 783-7965

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27055TNMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, PLLC CurrentSince Jun 28, 2020 Accepting new patients
Summit Medical Group, PLLC CurrentSince Jun 28, 2020 Accepting new patients
Summit Medical Group, PLLC Past Accepting new patients
Summit Medical Group, PLLC PastSince Jul 4, 2021 Accepting new patients

Locations

1404 Tusculum Blvd
Ste 3100
Greeneville, TN 37745
Phone (423) 638-4114

555 Justis Dr
Greeneville, TN 37745
Phone (423) 254-6460

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

Interoperability endpoints

  • Direct secure messaging: brandy.holder.1@20785.direct.athenahealth.com

Organizations & group practices 4

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": "1579132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1174153357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 DICK LONAS RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091382",
            "telephone_number": "865-584-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 TUSCULUM BLVD STE 3100",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377454648",
            "telephone_number": "423-638-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDER",
        "first_name": "BRANDY",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-16",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "27055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeneville, TN

Sources for this page

Verify at the official NPI Registry.