NPIMap

Individual provider Active NPI

Holly L Jeffreys, FNP-C

  • Family Nurse Practitioner
  • Panhandle, TX
National Provider Identifier
1316958408
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
648580 Issued in TX
Practice address
102 Hwy 60 E
Panhandle, TX 79068
Phone
(806) 532-2273
Fax
(806) 532-2276
NPI assigned
Aug 11, 2006
Last updated
Feb 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 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 648580 TX Primary

Addresses

Primary practice location

102 Hwy 60 E
Panhandle, TX 79068

Mailing address

PO Box 10
Panhandle, TX 79068-0010
Phone (806) 532-2273

Other identifiers 6

IdentifierTypeStateIssuer
8Y3245OtherTXBCBS
160981001MedicaidTX
8N4852OtherTXBCBS
133340100OtherTXSOUTHWEST LIFE & HEALTH
092485403MedicaidTX
133340100OtherTXFIRST CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050805000238 TX Practitioner - Nurse Practitioner 7214966779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Panhandle Family Care LLCGroup PAC ID 5294871240, 3 clinicians
Claude Family Medical Clinic, LLCGroup PAC ID 5496813065, 2 clinicians

Practice addresses (Care Compare)

102 US Hwy 60
Panhandle, TX 79068-7200
Phone (806) 532-2273

201 Parks St
Claude, TX 79019-3868

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
648580TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Panhandle Family Care LLC CurrentSince Feb 7, 2021 Accepting new patients
Panhandle Family Care LLC CurrentSince Aug 20, 2009 Accepting new patients
Panhandle Family Care LLC Past Accepting new patients
High Plains Radiological Association LLP Past Accepting new patients
FMC Clinics, P.a. Family Past Accepting new patients
FMC Medical Foundation, Inc Family Past Accepting new patients
Panhandle Emergency Physicians, P.a. Past Accepting new patients

Locations

1600 S FM 2381
Bushland, TX 79124
Phone (806) 310-9853

201 Parks St
Claude, TX 79019
Phone (806) 226-5611

Interoperability endpoints

  • Direct secure messaging: holly.jeffreys.1@25616.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/25616/brand/1/csg/1/fhir/r4

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Family Care Clinic of ClaudeClaude, TX, CCN 673819 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer (100%)		 Aug 20, 2009
Aug 20, 2009
Family Care Clinic of PanhandlePanhandle, TX, CCN 673962 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer		 Aug 20, 2009
Aug 20, 2009

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

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 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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1316958408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "PANHANDLE",
            "state": "TX",
            "postal_code": "790680010",
            "telephone_number": "806-532-2273",
            "fax_number": "806-532-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 HWY 60 E",
            "city": "PANHANDLE",
            "state": "TX",
            "postal_code": "79068",
            "telephone_number": "806-532-2273",
            "fax_number": "806-532-2276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFREYS",
        "first_name": "HOLLY",
        "middle_name": "L",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2021-02-02",
        "certification_date": "2021-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "648580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8Y3245",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160981001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8N4852",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHWEST LIFE & HEALTH",
            "identifier": "133340100",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092485403",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CARE",
            "identifier": "133340100",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panhandle, TX

Sources for this page

Verify at the official NPI Registry.