Individual provider Active NPI

Myra Lanette Holifield, DNP, FNP-BC

  • Family Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1902577265
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-120158 Issued in AL
Practice address
1813 6TH Ave S
Birmingham, AL 35233-1920
Phone
(205) 602-9229
NPI assigned
Sep 25, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 1-120158 AL Primary
Registered Nurse 163W00000X 1-120158 AL

Addresses

Primary practice location

1813 6TH Ave S
Birmingham, AL 35233-1920

Mailing address

1500 1St Ave N
Unit 3
Birmingham, AL 35203-1866
Phone (205) 545-5088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20220628000509 AL Practitioner - Nurse Practitioner 8820477441 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-120158ALMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Urgent Care LLC Single Specialty CurrentSince May 21, 2022 Accepting new patients
Rural Urgent Care LLC CurrentSince May 21, 2022 Accepting new patients
Signify Health, LLC Single Specialty CurrentSince Feb 18, 2025 Accepting new patients

Locations

4000 Eagle Point Corporate Dr
Birmingham, AL 35242
Phone (205) 317-0280

1500 1st Ave N
Unit 3
Birmingham, AL 35203
Phone (205) 545-5088

1925 W Main St
#120
Centre, AL 35960
Phone (256) 677-4552

1026 S Eufaula Ave
Eufaula, AL 36027
Phone (334) 687-5775

837 Battle St E
Talladega, AL 35160
Phone (256) 649-8134

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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.

NPI Registry JSON

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

{
    "created_epoch": "1632528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1902577265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 1ST AVE N",
            "address_2": "UNIT 3",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352031866",
            "telephone_number": "205-545-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331920",
            "telephone_number": "205-602-9229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLIFIELD",
        "first_name": "MYRA",
        "middle_name": "LANETTE",
        "name_prefix": "Mrs.",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-25",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-120158",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-120158",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.