Individual provider Active NPI

Jessica Holt

  • Audiologist
  • Lexington, SC
National Provider Identifier
1174906804
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AUD4025 Issued in SC
Practice address
157 Corley Mill Rd
Lexington, SC 29072-7600
Phone
(803) 256-2483
Fax
(803) 799-4624
NPI assigned
Jun 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AUD4025 SC Primary

Addresses

Primary practice location

157 Corley Mill Rd
Lexington, SC 29072-7600

Mailing address

157 Corley Mill Rd
Lexington, SC 29072-7600
Phone (803) 256-2483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150812007159 SC Practitioner - Qualified Audiologist 7719292374 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hearing Associates of South Carolina IncGroup PAC ID 9537109376, 5 clinicians

Practice addresses (Care Compare)

39 Varden Dr
Suite a
Aiken, SC 29803-5202
Phone (803) 641-6104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4025SCMDChiropractor
AUD4025SCMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hearing Associates of South Carolina, Inc. Audiologist CurrentSince Jul 1, 2018 Accepting new patients
Centa Medical Group PA CurrentSince Jul 9, 2015 Accepting new patients

Locations

39 Varden Dr
Ste A
Aiken, SC 29803
Phone (803) 641-6104

157 Corley Mill Rd
Lexington, SC 29072
Phone (803) 256-2483

Organizations & group practices 2

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": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435622400000",
    "number": "1174906804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 CORLEY MILL RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727600",
            "telephone_number": "803-256-2483",
            "fax_number": "803-799-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 CORLEY MILL RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727600",
            "telephone_number": "803-256-2483",
            "fax_number": "803-799-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-30",
        "last_updated": "2015-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "SC",
            "license": "AUD4025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.