Individual provider Active NPI

Derek Lamar Holt, DNP, FNP-BC

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1447470299
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R867446 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 815-3992
NPI assigned
Apr 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R867446 MS Primary

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

2500 N State St
JMM Suite 2525
Jackson, MS 39216-4500
Phone (601) 815-9528

Other identifiers 1

IdentifierTypeStateIssuer
P00668647OtherMSMEDICARE RR# UP-EM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20080903000310 MS Practitioner - Nurse Practitioner 0749356400 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mississippi Physicians LLPGroup PAC ID 7113193855, 24 clinicians

Practice addresses (Care Compare)

1225 N State St
Jackson, MS 39202-2064
Phone (601) 968-1000

Merit-based Incentive Payment System (MIPS)

Final score
89.9 of 100Reported as group
Quality
80.75
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R867446MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson County Hospital CurrentSince Oct 2, 2020 Accepting new patients
Jefferson County Hospital CurrentSince Oct 2, 2020 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Aug 1, 2012 Accepting new patients
Mississippi Physicians, LLP CurrentSince Mar 3, 2024 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Aug 1, 2012 Accepting new patients
Mississippi Physicians LLP Current Accepting new patients

Locations

870 Main St
Fayette, MS 39069
Phone (601) 786-3401

965 Avent Dr
Ste 100A
Grenada, MS 38901
Phone (662) 227-7000

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

2500 N State St
Ste 2525
Jackson, MS 39216
Phone (601) 984-6441

969 Lakeland Dr
Jackson, MS 39216
Phone (601) 200-4644

1815 Hospital Dr
Jackson, MS 39204
Phone (601) 815-4775

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13136/brand/1/csg/1/fhir/r4
  • Direct secure messaging: derek.holt.1@13136.direct.athenahealth.com
  • Direct secure messaging: dholt616231@direct.bmhcc.org

Organizations & group practices 6

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": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1447470299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "JMM SUITE 2525",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-815-9528",
            "fax_number": "601-984-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-815-3992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "DEREK",
        "middle_name": "LAMAR",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R867446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR#  UP-EM",
            "identifier": "P00668647",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.