Individual provider Active NPI

Shelley M Holland, NP

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1922273531
Registry record updated Jan 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
77447 Issued in OK
Practice address
223 NE 2ND St
Apt #103
Oklahoma City, OK 73104-4087
Phone
(303) 847-6514
NPI assigned
Apr 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2010

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 77447 OK Primary

Addresses

Primary practice location

223 NE 2ND St
Apt #103
Oklahoma City, OK 73104-4087

Mailing address

17301 Grove Hill Ter
Edmond, OK 73012-9709
Phone (405) 445-4550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20100204000319 OK Practitioner - Nurse Practitioner 4183793870 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13385TNMDAnatomic Pathology & Clinical Pathology Physician
77447OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Sep 15, 2011 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Sep 15, 2011 Accepting new patients
Ou Medicine Inc. Past Accepting new patients

Locations

920 Stanton L Young Blvd
Ste 1140
Oklahoma City, OK 73104

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

Organizations & group practices 5

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": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262822400000",
    "number": "1922273531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17301 GROVE HILL TER",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730129709",
            "telephone_number": "405-445-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 NE 2ND ST",
            "address_2": "APT #103",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044087",
            "telephone_number": "303-847-6514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "SHELLEY",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2010-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "77447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.