Individual provider Active NPI

Heather C Holst, FNP

  • Family Nurse Practitioner
  • Lakeland, FL
National Provider Identifier
1609592963
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11022518 Issued in FL
Practice address
1600 Lakeland Hills Blvd
Lakeland, FL 33805-3065
Phone
(863) 680-7000
Fax
(866) 264-8519
NPI assigned
Oct 18, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11022518 FL
Family Nurse Practitioner 363LF0000X APRN11022518 FL Primary

Addresses

Primary practice location

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3065

Mailing address

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3065
Phone (863) 680-7000

Other practice location 1

2300 E County Road 540A
Lakeland, FL 33813-3825
Phone (863) 680-7300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hholst21260@direct.watsonclinicad.com Watson Clinic LLP

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
I20221102003039 FL Practitioner - Nurse Practitioner 3678940707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Watson Clinic LLPGroup PAC ID 1456258979, 365 clinicians

Practice addresses (Care Compare)

2300 E County Rd
540A
Lakeland, FL 33813-3825
Phone (863) 607-3333

Merit-based Incentive Payment System (MIPS)

Final score
87.18 of 100Reported as apm
Quality
70.68
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11022518FLMDFamily Medicine Physician
APRN11022518FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Watson Clinic LLP Family Medicine CurrentSince Dec 1, 2022 Accepting new patients

Locations

1600 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 680-7190

2300 E County Road 540A
Lakeland, FL 33813
Phone (863) 607-3333

1430 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 680-7337

Organizations & group practices 1

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": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1609592963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053065",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053065",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 E County Road 540A",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338133825",
            "country_code": "US",
            "telephone_number": "863-680-7300",
            "fax_number": "866-264-8519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLST",
        "first_name": "HEATHER",
        "middle_name": "C",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-11-30",
        "certification_date": "2022-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "11022518",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11022518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hholst21260@direct.watsonclinicad.com",
            "affiliation": "Y",
            "endpointDescription": "Direct Messaging Address",
            "affiliationName": "Watson Clinic LLP",
            "address_1": "1430 Lakeland Hills Blvd",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338053202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.