Kailey Victoria Holm

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

11411 Issued in AZ

Practice address

14961 W Bell Rd Ste 175
Surprise, AZ 85374-3220

Phone

(623) 547-7205

NPI assigned

Jun 3, 2024

Last updated

Aug 4, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1902647241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14961 W BELL RD STE 175",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853743220",
            "telephone_number": "623-547-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14961 W BELL RD STE 175",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853743220",
            "telephone_number": "623-547-7205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W Thomas Rd Ste 700",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850134295",
            "country_code": "US",
            "telephone_number": "602-406-7048",
            "fax_number": "602-406-7650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLM",
        "first_name": "KAILEY",
        "middle_name": "VICTORIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "11411",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "11411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maressa Holland
• Daniel Holloway, OD
• George Allen Holloway Jr., MD
• Jennifer Nowell Holloway, LMFT
• Hollyhock Assisted Living LLC
• Jessica L Holmquist, PA-C
• Paige Alexandra Holt, RN
• Steven R Holt, OD
• Honor Beehavior Consultants, LLC
• Honorhealth (HonorHealth Complete Care)

• Medical Physician Assistant in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.