Individual provider Active NPI

Amy Leanne Holzworth, ARNP-BC

  • Nurse Practitioner
  • Clearwater, FL
National Provider Identifier
1316544000
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11005745 Issued in FL
Practice address
1055 S Fort Harrison Ave
Clearwater, FL 33756-3905
Phone
(727) 442-6245
NPI assigned
Oct 6, 2020
Last updated
Oct 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11005745 FL Primary

Addresses

Primary practice location

1055 S Fort Harrison Ave
Clearwater, FL 33756-3905

Mailing address

5113 Horseshoe PL NE
Saint Petersburg, FL 33703-4129
Phone (765) 252-8142

Other names 1

  • Amy Leanne Harshman Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 7274976784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201221001812 FL Practitioner - Nurse Practitioner 0648682450 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11005745FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiorenal Therapeutics LLC CurrentSince Mar 21, 2023 Accepting new patients

Locations

6817 Southpoint Pkwy
Ste 203
Jacksonville, FL 32216
Phone (904) 256-9202

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1316544000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5113 HORSESHOE PL NE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337034129",
            "telephone_number": "765-252-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 S FORT HARRISON AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563905",
            "telephone_number": "727-442-6245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLZWORTH",
        "first_name": "AMY",
        "middle_name": "LEANNE",
        "credential": "ARNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-06",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11005745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "7274976784",
            "affiliation": "N",
            "address_1": "1055 S Fort Harrison Ave",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337563905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "HARSHMAN",
            "middle_name": "LEANNE",
            "credential": "ARNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.