Randi Moore Hollis, FNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5038133-4405 Issued in UT

Practice address

1220 E 3900 S Ste 1F
Salt Lake City, UT 84124-1327

Phone

(801) 262-5711

NPI assigned

Sep 23, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

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, 2018

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Catholic Health Initiatives Colorado 1,230 clinicians

Lotus Center Inc 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rhollis180855@direct.med.utah.edu

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.

• Lotus Center Inc

  • Community/Behavioral Health Agency
  • Salt Lake City, UT
  • NPI 1992167118

  UT

  Medicare reassignment Care Compare group NPD
• Catholic Health Initiatives Colorado

  • Prescribing (Medical) Psychologist
  • West Valley City, UT
  • NPI 1942903562

  UT

  Medicare reassignment NPD
• Karen W. Malm, PH.D., P.C.

  • Psychologist
  • Park City, UT
  • NPI 1871701656

  UT

  Medicare reassignment NPD
• Physician Group of Utah Inc

  • Specialist
  • South Jordan, UT
  • NPI 1477676930

  UT

  Medicare reassignment NPD
• University of Utah Behavioral Health Services

  • Psychiatry Physician
  • Salt Lake City, UT
  • NPI 1740688613

  UT

  Medicare reassignment NPD
• University of Utah Pediatric Acuity Care

  • Pediatric Critical Care Medicine Physician
  • Salt Lake City, UT
  • NPI 1619325131

  UT

  Medicare reassignment NPD
• University of Utah Pediatric Behavioral Health Services

  • Developmental - Behavioral Pediatrics Physician
  • Salt Lake City, UT
  • NPI 1649631599

  UT

  Medicare reassignment NPD
• Catholic Health Initiatives Colorado

  • Pulmonary Disease Physician
  • Lehi, UT
  • NPI 1184326035
  NPD
• University of Utah Behavioral Health Services

  • Psychiatry Physician
  • Salt Lake City, UT
  • NPI 1679937700
  NPD
• University of Utah Behavioral Health Services

  • Sports Medicine (Psychiatry & Neurology) Physician
  • Salt Lake City, UT
  • NPI 1740158955
  NPD
• University of Utah Pediatric Acuity Care

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Salt Lake City, UT
  • NPI 1538523675
  NPD
• University of Utah Pediatric Acuity Care

  • Pediatric Hospice and Palliative Medicine Physician
  • Salt Lake City, UT
  • NPI 1851898365
  NPD

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1346642121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 E 3900 S STE 1F",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241327",
            "telephone_number": "801-262-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 E 3900 S STE 1F",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241327",
            "telephone_number": "801-262-5711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4052 W 3390 S",
            "address_2": "Ste 105",
            "address_purpose": "LOCATION",
            "city": "West Valley City",
            "state": "UT",
            "postal_code": "84120",
            "country_code": "US",
            "telephone_number": "801-964-3111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLIS",
        "first_name": "RANDI",
        "middle_name": "MOORE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-23",
        "last_updated": "2023-07-07",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "5038133-4405",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "5038133-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rhollis180855@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Scott Matthias Hollingshaus, M.D.
• Darren Trace Hollingsworth
• Gayle Hollingsworth, CPS
• Canice Hollins
• Sandra Hollins
• Edward Martin Holloway
• Jessica Holloway
• Tifani Johanna Holloway, CSW
• Taylor Aubrey Holm Bundy, DO
• Hannah Holm

• All providers in Salt Lake City, UT
• Psychiatric/Mental Health Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; 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.