Individual provider Active NPI

Sandra D Holley, DNP, APRN, FNP-C

  • Family Nurse Practitioner
  • Waco, TX
National Provider Identifier
1659180123
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1189443 Issued in TX
Practice address
3500 Hillcrest Dr Ste 1
Waco, TX 76708-3144
Phone
(254) 741-6641
Fax
(254) 537-4693
NPI assigned
Dec 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F12240796 TX
Family Nurse Practitioner 363LF0000X 1189443 TX Primary

Addresses

Primary practice location

3500 Hillcrest Dr Ste 1
Waco, TX 76708-3144

Mailing address

101 W Louis Henna Blvd Ste 300
Austin, TX 78728-1203
Phone (512) 244-4272

Other practice location 1

625 McClintic Dr
Groesbeck, TX 76642-2135
Phone (254) 741-6641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250204003889 TX Practitioner - Nurse Practitioner 9638609746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mark Malone MD PAGroup PAC ID 2567369424, 102 clinicians

Practice addresses (Care Compare)

3500 Hillcrest Dr
Suite 1
Waco, TX 76708-3144
Phone (254) 741-6641

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1189443TXMDFamily Nurse Practitioner
F12240796TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Malone MD PA CurrentSince Jan 31, 2025 Accepting new patients
Mark Malone, MD PA CurrentSince Jan 31, 2025 Accepting new patients
Mark Malone MD PA CurrentSince Jan 31, 2025 Accepting new patients

Locations

101 W Louis Henna Blvd
Ste 300
Austin, TX 78728

6000 S Mopac Expy
Ste 100
Austin, TX 78749

1106 College St
Ste C
Bastrop, TX 78602
Phone (512) 244-2895

625 McClintic Dr
Groesbeck, TX 76642
Phone (254) 399-0741

3500 Hillcrest Dr
Ste 1
Waco, TX 76708

Organizations & group practices 3

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.

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": "1735516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1659180123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W LOUIS HENNA BLVD STE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787281203",
            "telephone_number": "512-244-4272",
            "fax_number": "512-244-2895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 HILLCREST DR STE 1",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767083144",
            "telephone_number": "254-741-6641",
            "fax_number": "254-537-4693"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 McClintic Dr",
            "address_purpose": "LOCATION",
            "city": "Groesbeck",
            "state": "TX",
            "postal_code": "766422135",
            "country_code": "US",
            "telephone_number": "254-741-6641",
            "fax_number": "254-537-4693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLEY",
        "first_name": "SANDRA",
        "middle_name": "D",
        "credential": "DNP, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-30",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "F12240796",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1189443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.