Individual provider Active NPI

Pamela S Holt, NP

  • Family Nurse Practitioner
  • Roanoke, VA
National Provider Identifier
1194917500
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024167490 Issued in VA
Practice address
1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone
(540) 981-8574
Fax
(540) 983-1133
NPI assigned
Aug 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2008

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 0024167490 VA Primary

Addresses

Primary practice location

1906 Belleview Ave SE
Roanoke, VA 24014-1838

Mailing address

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-8574

Other identifiers 2

IdentifierTypeStateIssuer
0024167490OtherVALICENSE
1194917500MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20071026000437 VA Practitioner - Nurse Practitioner 8325135098 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024167490VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Oct 8, 2007 Accepting new patients
Carilion Medical Center CurrentSince Oct 8, 2007 Accepting new patients

Locations

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

2001 Crystal Spring Ave SW
Ste 201
Roanoke, VA 24014
Phone (540) 853-0100

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

Interoperability endpoints

  • Direct secure messaging: pholt18398@direct.carilionclinic.org

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": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210118400000",
    "number": "1194917500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 BELLEVIEW AVE SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141838",
            "telephone_number": "540-981-8574",
            "fax_number": "540-983-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 BELLEVIEW AVE SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141838",
            "telephone_number": "540-981-8574",
            "fax_number": "540-983-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "PAMELA",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-10",
        "last_updated": "2008-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024167490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0024167490",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194917500",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.