NPIMap

Individual provider Active NPI

Holly Nicole Reed, FNP-BC

  • Family Nurse Practitioner
  • Puxico, MO
National Provider Identifier
1235487885
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2012029026 Issued in MO
Practice address
130 E Harbin Ave
Puxico, MO 63960-9104
Phone
(573) 222-3556
Fax
(573) 222-3127
NPI assigned
Aug 29, 2012
Last updated
Sep 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

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 2012029026 MO Primary

Addresses

Primary practice location

130 E Harbin Ave
Puxico, MO 63960-9104

Mailing address

130 E Harbin Ave
Puxico, MO 63960-9104
Phone (573) 222-3556

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address holly.reed.1@8825.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141202000689 MO Practitioner - Nurse Practitioner 2961550900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Missouri, Columbia School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

130 E Harbin Ave
Puxico, MO 63960-9104
Phone (573) 222-3556

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012029026MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Poplar Bluff Regional Medical Center LLC CurrentSince Oct 1, 2014 Accepting new patients
Poplar Bluff Regional Medical Center, LLC CurrentSince Oct 1, 2014 Accepting new patients
Poplar Bluff Regional Medical Center LLC Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

130 E Harbin Ave
Puxico, MO 63960
Phone (573) 222-3556

Interoperability endpoints

  • Direct secure messaging: holly.reed.1@8825.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 5

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": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1235487885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E HARBIN AVE",
            "city": "PUXICO",
            "state": "MO",
            "postal_code": "639609104",
            "telephone_number": "573-222-3556",
            "fax_number": "573-222-3127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E HARBIN AVE",
            "city": "PUXICO",
            "state": "MO",
            "postal_code": "639609104",
            "telephone_number": "573-222-3556",
            "fax_number": "573-222-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REED",
        "first_name": "HOLLY",
        "middle_name": "NICOLE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2012029026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "holly.reed.1@8825.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "address_1": "130 E Harbin Ave",
            "city": "Puxico",
            "state": "MO",
            "country_code": "US",
            "postal_code": "639609104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Puxico, MO

Sources for this page

Verify at the official NPI Registry.