Heather Leigh Holt, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085003564 Issued in IL

Practice address

807 W Craft St
Robinson, IL 62454-1137

Phone

(618) 546-5052

Fax

(618) 544-2094

NPI assigned

Sep 29, 2009

Last updated

Jun 16, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Heather Leigh Holliday Former name

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michael W Elliott II

  • Rural Health Clinic/Center
  • Robinson, IL
  • NPI 1548267693
  Medicare reassignment
• Michael W Elliott II MD

  • Rural Health Clinic/Center
  • Robinson, IL
  • NPI 1417989237
  NPD

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434412800000",
    "number": "1184958787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 W CRAFT ST",
            "city": "ROBINSON",
            "state": "IL",
            "postal_code": "624541137",
            "telephone_number": "618-546-5052",
            "fax_number": "618-544-2094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 W CRAFT ST",
            "city": "ROBINSON",
            "state": "IL",
            "postal_code": "624541137",
            "telephone_number": "618-546-5052",
            "fax_number": "618-544-2094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "HEATHER",
        "middle_name": "LEIGH",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-29",
        "last_updated": "2015-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT LICENSE",
            "identifier": "085.003564",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA CERTIFICATION",
            "identifier": "1088888",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "HOLLIDAY",
            "middle_name": "LEIGH",
            "credential": "PHYSICIAN ASSISTANT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Robinson, IL
• Providers in Robinson, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.