Individual provider Active NPI

Angela Marie Holles, APRN, NP-C

  • Family Nurse Practitioner
  • Excelsior Springs, MO
National Provider Identifier
1184922759
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2011006205 Issued in MO
Practice address
1345 N Jesse James Rd
Excelsior Springs, MO 64024-1120
Phone
(816) 630-9411
Fax
(855) 642-2047
NPI assigned
Mar 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 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 2011006205 MO Primary

Addresses

Primary practice location

1345 N Jesse James Rd
Excelsior Springs, MO 64024-1120

Mailing address

1345 N Jesse James Rd
Excelsior Springs, MO 64024-1120
Phone (816) 630-9411

Other identifiers 1

IdentifierTypeStateIssuer
1184922759MedicaidMO

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
I20160407001500 MO Practitioner - Nurse Practitioner 7113225152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Schreier Family Medicine LLCGroup PAC ID 5890966048, 3 clinicians

Practice addresses (Care Compare)

1345 N Jesse James Rd
Excelsior Springs, MO 64024-1120
Phone (816) 630-9411

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2011006205MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Schreier Family Medicine LLC CurrentSince Oct 18, 2017 Accepting new patients
Excelsior Springs Pediatric Clinic Family Past Accepting new patients
Northland Gastroenterology PastSince Apr 11, 2021 Accepting new patients

Locations

1006 N Jesse James Rd
Ste 1
Excelsior Springs, MO 64024
Phone (816) 630-9411

1345 N Jesse James Rd
Exclsor Sprgs, MO 64024
Phone (816) 630-0900

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CAJHCA/Endpoint/CAJHCA
  • FHIR API: https://fhir4.healow.com/fhir/r4/CAJHCA

Organizations & group practices 3

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.

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": "1299456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1184922759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 N JESSE JAMES RD",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640241120",
            "telephone_number": "816-630-9411",
            "fax_number": "855-642-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 N JESSE JAMES RD",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640241120",
            "telephone_number": "816-630-9411",
            "fax_number": "855-642-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLES",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "credential": "APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-07",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2011006205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184922759",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Excelsior Springs, MO

Sources for this page

Verify at the official NPI Registry.