Jessica Renee Holman, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP10658 Issued in AZ

Practice address

1755 Roadrunner LN
Chino Valley, AZ 86323-7105

Phone

(928) 848-7553

NPI assigned

Oct 2, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Renee Booth Former name

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arizona Post-Acute Medical Services 1 PCGroup PAC ID 4688951239, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012
• Verde Valley Medical Center Hospital, Cottonwood, AZ, CCN 030007

Merit-based Incentive Payment System (MIPS)

Final score

89.72 of 100Reported as apm

Quality

72.97

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Arizona Post-Acute Medical Services 1 PC

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1093254419
  Medicare reassignment Care Compare group NPD
• CS Pacs 3 West LLC

  • Hospitalist Physician
  • Sunnyvale, CA
  • NPI 1073378238

  AZ

  Medicare reassignment NPD
• NM Pacs 2 LLC

  • Hospitalist Physician
  • Albuquerque, NM
  • NPI 1366928749

  AZ

  Medicare reassignment NPD
• Hospitalists of Arizona, LLC

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1578564860
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Verde Valley Medical Center

  • General Acute Care Hospital
  • Cottonwood, AZ
  • NPI 1346291648
  Care Compare affiliation
• Verde Valley Medical Center

  • General Acute Care Hospital
  • Sedona, AZ
  • NPI 1538608716
  Care Compare affiliation
• Yavapai Community Hospital Association

  • General Acute Care Hospital
  • Prescott, AZ
  • NPI 1902897820
  Care Compare affiliation

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506902400000",
    "number": "1336659515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 ROADRUNNER LN",
            "city": "CHINO VALLEY",
            "state": "AZ",
            "postal_code": "863237105",
            "telephone_number": "928-848-7553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 ROADRUNNER LN",
            "city": "CHINO VALLEY",
            "state": "AZ",
            "postal_code": "863237105",
            "telephone_number": "928-848-7553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMAN",
        "first_name": "JESSICA",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-02",
        "last_updated": "2017-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP10658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BOOTH",
            "middle_name": "RENEE",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathleen M Heckel Hicks, FNP-C
• High Resonance LLC
• Laurie Anne Hill, RDN
• Leighann Yvonne Hjelm
• Jody Hoitt, BSN RN CRRN
• Horizon Dental Group LLC
• Hospice Family Care, Inc.
• Susan A Howell, APRN
• Mariah Hoyt
• Jacob Hrkal, DO

• Family Nurse Practitioner in Chino Valley, AZ
• Providers in Chino Valley, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.