Kelly L Holt, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209007570 Issued in IL

Practice address

2512 Hurst Dr.
Mattoon, IL 61938-9388

Phone

(217) 258-5900

Fax

(217) 258-5904

NPI assigned

Sep 22, 2008

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

Other names 1

• Kelly L. Cunico Former name

Medicare fee-for-service enrollment

Enrolled in IL

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hoopeston Community Memorial HospitalGroup PAC ID 3577456037, 142 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carle Hoopeston Regional Health Center Hospital, Hoopeston, IL, CCN 141316

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Hoopeston Community Memorial Hospital

  • Internal Medicine Physician
  • Hoopeston, IL
  • NPI 1043683014
  Medicare reassignment Care Compare group NPD
• Carle Health Care Incorporated

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment NPD
• Hoopeston Community Memorial Hospital

  • Critical Access Hospital
  • Hoopeston, IL
  • NPI 1366480873
  NPD
• Hoopeston Community Memorial Hospital

  • Rural Health Clinic/Center
  • Hoopeston, IL
  • NPI 1578504544
  NPD
• Carle Health Care Incorporated

  • Durable Medical Equipment & Medical Supplies
  • Champaign, IL
  • NPI 1114240876
  NPD (past)

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

• Hoopeston Community Memorial Hospital

  • Ambulance
  • Hoopeston, IL
  • NPI 1164594594

  Hospital

  Care Compare affiliation
• Hoopeston Community Memorial Hospital

  • Critical Access Hospital
  • Hoopeston, IL
  • NPI 1366480873
  Care Compare affiliation

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

{
    "created_epoch": "1222041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416960000000",
    "number": "1407006828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "BWPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-383-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 HURST DR.",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619389388",
            "telephone_number": "217-258-5900",
            "fax_number": "217-258-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "KELLY",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-22",
        "last_updated": "2014-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041-335540",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209007570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "CUNICO",
            "middle_name": "L.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jenny Lyn Hildebrand
• James Hildebrandt, D.O.
• Dorothy Jeanine Hinshaw, CNP
• Brandi Nicole Hobbs, COTA/L
• Lori Ann Holland, LSW
• Donna R Homann
• Ellen C Homann, M.S, R.D., L.D.N
• Honeycomb Healing Arts, PLLC
• Hoopeston Community Memorial Hospital
• Casey J. Hooten, M.S.

• Family Nurse Practitioner in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2014; 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.