Individual provider Active NPI

Eileen Holt, NP

  • Family Nurse Practitioner
  • Ellisville, MO
National Provider Identifier
1629439054
Registry record updated Dec 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2016005301 Issued in MO
Practice address
225 Clarkson Rd
Ellisville, MO 63011-2278
Phone
(636) 685-7715
NPI assigned
Mar 12, 2016
Last updated
Dec 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2024

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 2016005301 MO Primary

Addresses

Primary practice location

225 Clarkson Rd
Ellisville, MO 63011-2278

Mailing address

12855 N 40 Dr Ste 275
Saint Louis, MO 63141-8667
Phone (314) 395-7699

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nabil.ahmad@amr.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20171215000351 MO Practitioner - Nurse Practitioner 3375801632 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Southern Illinois University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westglen Family Physicians LLCGroup PAC ID 3678506102, 8 clinicians

Practice addresses (Care Compare)

225 Clarkson Rd
Ellisville, MO 63011-2278
Phone (636) 685-7715

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Westglen Family Physicians, LLC CurrentSince Sep 20, 2024 Accepting new patients
Amr Pain & Spine Clinic LLC CurrentSince Jan 14, 2020 Accepting new patients

Locations

225 Clarkson Rd
Ellisville, MO 63011
Phone (636) 230-5050

12855 N 40 Dr
Ste 275
Saint Louis, MO 63141
Phone (314) 312-4034

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1457740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734998400000",
    "number": "1629439054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12855 N 40 DR STE 275",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418667",
            "telephone_number": "314-395-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 CLARKSON RD",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112278",
            "telephone_number": "636-685-7715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "EILEEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-12",
        "last_updated": "2024-12-24",
        "certification_date": "2024-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016005301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nabil.ahmad@amr.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "12855 N 40 Dr Ste 275",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631418667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ellisville, MO

Sources for this page

Verify at the official NPI Registry.