Individual provider Active NPI

Jessica L Holt, CRNP

  • Family Nurse Practitioner
  • Cranberry Township, PA
National Provider Identifier
1851630438
Registry record updated Feb 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP012391 Issued in PA
Practice address
5 Saint Francis Way
Cranberry Township, PA 16066-5119
Phone
(724) 772-5350
NPI assigned
Feb 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2013

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 SP012391 PA Primary

Addresses

Primary practice location

5 Saint Francis Way
Cranberry Township, PA 16066-5119

Mailing address

328 Woodridge Dr
Washington, PA 15301-8329
Phone (724) 986-2792

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20130727000161 SC Practitioner - Nurse Practitioner 3173763026 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Hospitalist Services PCGroup PAC ID 3476855420, 301 clinicians

Practice addresses (Care Compare)

1000 Wellness Way
Fort Mill, SC 29715-7315
Phone (803) 329-1234

Hospital & facility affiliations

  • Piedmont Medical Center Hospital, Rock Hill, SC, CCN 420002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP012391PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Hospitalist Services PC CurrentSince Feb 1, 2019 Accepting new patients
Cogent Healthcare of Georgia PC CurrentSince Dec 1, 2016 Accepting new patients
Piedmont Pulmonology, LLC Past Accepting new patients

Locations

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

1000 Wellness Way
Fort Mill, SC 29715
Phone (803) 329-1234

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

222 Herlong Ave S
Rock Hill, SC 29732
Phone (803) 324-1950

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": "1359763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359763200000",
    "number": "1851630438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 WOODRIDGE DR",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153018329",
            "telephone_number": "724-986-2792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SAINT FRANCIS WAY",
            "city": "CRANBERRY TOWNSHIP",
            "state": "PA",
            "postal_code": "160665119",
            "telephone_number": "724-772-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-02",
        "last_updated": "2013-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP012391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranberry Township, PA

Sources for this page

Verify at the official NPI Registry.