Individual provider Active NPI

Amy Marie Holder, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1679900740
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2013030761 Issued in MO
Practice address
400 S Kingshighway Blvd
Saint Louis, MO 63110-1014
Phone
(314) 362-9123
Fax
(314) 747-3338
NPI assigned
Oct 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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 2013030761 MO Primary

Addresses

Primary practice location

400 S Kingshighway Blvd
Saint Louis, MO 63110-1014

Mailing address

660 S Euclid Ave
CB 8072
Saint Louis, MO 63110-1010
Phone (314) 362-9123

Other identifiers 2

IdentifierTypeStateIssuer
ENROLLEDMedicaidIL
1679900740MedicaidMO

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
I20140324001482 MO Practitioner - Nurse Practitioner 4789815341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Medical Physicians LLCGroup PAC ID 6507129699, 9 clinicians
Emergency Physicians of St Lukes LLCGroup PAC ID 3779714142, 63 clinicians

Practice addresses (Care Compare)

12304 Manchester Rd
Des Peres, MO 63131-4315
Phone (314) 965-6871

2325 Dougherty Ferry Rd
Suite 104
Saint Louis, MO 63122-3356
Phone (314) 821-6889

233 Clarkson Rd
Ellisville, MO 63011-2219
Phone (636) 256-8644

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179

Merit-based Incentive Payment System (MIPS)

Final score
92.71 of 100Reported as apm
Quality
82.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013030761MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Medical Physicians LLC CurrentSince Jun 1, 2025 Accepting new patients
Emergency Physicians of St. Luke'S, LLC CurrentSince Jan 4, 2022 Accepting new patients
Physician Specialists of St Lukes LLC Past Accepting new patients

Locations

12304 Manchester Rd
Des Peres, MO 63131
Phone (314) 965-6871

233 Clarkson Rd
Ellisville, MO 63011
Phone (636) 256-8644

2325 Dougherty Ferry Rd
Ste 104
Saint Louis, MO 63122
Phone (314) 821-6889

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": "1380758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1679900740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "CB 8072",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-362-9123",
            "fax_number": "314-747-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S KINGSHIGHWAY BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101014",
            "telephone_number": "314-362-9123",
            "fax_number": "314-747-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDER",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-03",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2013030761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679900740",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.