Individual provider Active NPI

Holly Michaux Enders, ARNP

  • Primary Care Nurse Practitioner
  • Key West, FL
National Provider Identifier
1740239961
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
ARNP9476466 Issued in FL
Practice address
1111 12TH. Street
Key West, FL 33040
Phone
(305) 293-5015
Fax
(305) 293-5016
NPI assigned
May 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9476466 FL
Primary Care Nurse Practitioner 363LP2300X 0024174157 VA
Primary Care Nurse Practitioner 363LP2300X ARNP9476466 FL Primary

Addresses

Primary practice location

1111 12TH. Street
Key West, FL 33040

Mailing address

1111 12TH. St. Ste. 203
Key West, FL 33040
Phone (305) 293-5015

Other practice location 1

22 S Greene St
Baltimore, MD 21201-1544
Phone (410) 328-5196

Other practice location 2

1111 12th St
Key West, FL 33040-4088
Phone (305) 293-5015

Other identifiers 2

IdentifierTypeStateIssuer
699858500MedicaidMD
613336-01OtherMDBLUE CROSS/BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9476466FLMDPrimary Care Nurse Practitioner
0024174157VAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Physicians P.a. Current Accepting new patients
University of Maryland Physicians PA Current Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1740239961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 12TH. ST. STE. 203",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "33040",
            "telephone_number": "305-293-5015",
            "fax_number": "305-293-5016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 12TH. STREET",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "33040",
            "telephone_number": "305-293-5015",
            "fax_number": "305-293-5016"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 S Greene St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011544",
            "country_code": "US",
            "telephone_number": "410-328-5196",
            "fax_number": "410-328-0248",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 12th St",
            "address_purpose": "LOCATION",
            "city": "Key West",
            "state": "FL",
            "postal_code": "330404088",
            "country_code": "US",
            "telephone_number": "305-293-5015",
            "fax_number": "305-293-5016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENDERS",
        "first_name": "HOLLY",
        "middle_name": "MICHAUX",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-06",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9476466",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "VA",
            "license": "0024174157",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP9476466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "699858500",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "613336-01",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Key West, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.