Individual provider Active NPI

Patrice Marlene Holliday, FNP-C

  • Family Nurse Practitioner
  • Bradenton, FL
National Provider Identifier
1407288053
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11013337 Issued in FL
Practice address
4401 Cortez Rd W
Bradenton, FL 34210-3142
Phone
(941) 357-5550
Fax
(941) 792-7152
NPI assigned
Aug 6, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN18610 SC
Family Nurse Practitioner 363LF0000X 9232802 FL
Family Nurse Practitioner 363LF0000X 2016035060 MO
Family Nurse Practitioner 363LF0000X APRN11013337 FL Primary

Addresses

Primary practice location

4401 Cortez Rd W
Bradenton, FL 34210-3142

Mailing address

7611 25TH Ave W
Bradenton, FL 34209-5236
Phone (941) 376-1944

Other names 1

  • Patrice Marlene Burnett Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20240507001607 FL Practitioner - Nurse Practitioner 9133359474 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9232802FLMDFamily Nurse Practitioner
APRN11013337FLMDFamily Nurse Practitioner
APRN18610SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Specialists LLC CurrentSince Apr 29, 2024 Accepting new patients
Florida Medical Specialists, LLC CurrentSince Apr 29, 2024 Accepting new patients
Florida Medical Specialists LLC Current Accepting new patients
Best Value Healthcare LLC Past Accepting new patients
Florida Medical Specialists LLC Past Accepting new patients

Locations

4401 Cortez Rd W
Bradenton, FL 34210
Phone (941) 357-5550

3830 Bee Ridge Rd
Ste 301
Sarasota, FL 34233
Phone (941) 923-1872

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1375747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1407288053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7611 25TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342095236",
            "telephone_number": "941-376-1944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 CORTEZ RD W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342103142",
            "telephone_number": "941-357-5550",
            "fax_number": "941-792-7152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIDAY",
        "first_name": "PATRICE",
        "middle_name": "MARLENE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-06",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "APRN18610",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9232802",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016035060",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11013337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICE",
            "last_name": "BURNETT",
            "middle_name": "MARLENE",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.