Active NPI
Jody Lynn Holtz, FNP-C
- Family Nurse Practitioner
- Farmville, NC
National Provider Identifier
1699324657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 5012214
- Practice address
- 3681 N Main St
Farmville, NC 27828-1464 - Phone
- (252) 753-7141
- Fax
- (252) 753-5834
- NPI assigned
- Sep 11, 2019
- Last updated
- Mar 23, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 5012214 | NC | Primary |
Addresses
Primary practice location
3681 N Main St
Farmville, NC 27828-1464
Mailing address
3681 N Main St
Farmville, NC 27828-1464
Phone (252) 753-7141
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
444 SW Ctr St
Faison, NC 28341-8820
Phone (910) 267-0421
460 SW Ctr St
Faison, NC 28341-8820
Phone (910) 267-0951
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5012214 | NC | MD | Family Nurse Practitioner |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Goshen Medical Center - Duplin
- Federally Qualified Health Center (FQHC)
- Kenansville, NC
- NPI 1962124974
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647993600000",
"number": "1699324657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3681 N MAIN ST",
"city": "FARMVILLE",
"state": "NC",
"postal_code": "278281464",
"telephone_number": "252-753-7141",
"fax_number": "252-753-5834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3681 N MAIN ST",
"city": "FARMVILLE",
"state": "NC",
"postal_code": "278281464",
"telephone_number": "252-753-7141",
"fax_number": "252-753-5834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLTZ",
"first_name": "JODY",
"middle_name": "LYNN",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-11",
"last_updated": "2022-03-23",
"certification_date": "2022-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "5012214",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.