Jacqueline Summer Holzbaur, MSN, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

26NJ14939800 Issued in NJ

Practice address

12 Samantha LN
Hamilton, NJ 08619-4312

Phone

(609) 815-6653

NPI assigned

Oct 18, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacqueline.holzbaur.1@23060.direct.athenahealth.com

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.

• Live Urgent Care LLC

  • Family Medicine Physician
  • Bellmawr, NJ
  • NPI 1407439870
  Medicare reassignment NPD

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

{
    "created_epoch": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1366224834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 SAMANTHA LN",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086194312",
            "telephone_number": "609-815-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 SAMANTHA LN",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086194312",
            "telephone_number": "609-815-6653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLZBAUR",
        "first_name": "JACQUELINE",
        "middle_name": "SUMMER",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-18",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR18821500",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN689119",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ14939800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carmen Lynn Hodges, PSYD, LCADC
• Kristin Hoffman, MS, RDN
• Holistic Counseling Solution
• Penelope Anne Holloway, M.A.,BCBA
• Michele Denyse Holowatch, M.A., CCC/SLP
• Anne Conyers Hom, PHARMD
• Home Instead Senior Care
• Homestead Senior Living, LLC
• Hope Harbor Behavioral Health LLC
• Hope Harbor Community Care, LLC.

• Nurse Practitioner in Hamilton, NJ
• Providers in Hamilton, NJ by specialty
• Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.