Individual provider Active NPI

Deborah Holderfield, CRNP

  • Adult Health Nurse Practitioner
  • Sylacauga, AL
National Provider Identifier
1962765164
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
1-113630 Issued in AL
Practice address
291 James Payton Blvd
Sylacauga, AL 35150-8047
Phone
(256) 249-0028
Fax
(265) 249-0019
NPI assigned
Jun 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 1-113630 AL Primary

Addresses

Primary practice location

291 James Payton Blvd
Sylacauga, AL 35150-8047

Mailing address

291 James Payton Blvd
Sylacauga, AL 35150-8047
Phone (256) 249-0028

Other identifiers 3

IdentifierTypeStateIssuer
1-113630OtherALCRNP COLLABORATION LICENSE
3687OtherALPRESCRIBING NUMBER
A0512010OtherAANP CERTIFICATION

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
I20130118000237 AL Practitioner - Nurse Practitioner 8527211739 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-113630ALMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Merit Health Care, PC Current Accepting new patients
Merit Health Care, PC Adult Health CurrentSince Nov 1, 2012 Accepting new patients

Locations

21342 AL Highway 9
Goodwater, AL 35072
Phone (256) 743-1300

291 James Payton Blvd
Sylacauga, AL 35150
Phone (256) 245-0297

216 Battle St E
Ste A
Talladega, AL 35160
Phone (256) 249-0028

216 Battle St E
Talladega, AL 35160
Phone (256) 761-1889

729 Battle St E
Talladega, AL 35160
Phone (256) 249-0028

Interoperability endpoints

  • Direct secure messaging: deborah.holderfield@merit.directbygreenway.com

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": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1962765164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 JAMES PAYTON BLVD",
            "city": "SYLACAUGA",
            "state": "AL",
            "postal_code": "351508047",
            "telephone_number": "256-249-0028",
            "fax_number": "256-249-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 JAMES PAYTON BLVD",
            "city": "SYLACAUGA",
            "state": "AL",
            "postal_code": "351508047",
            "telephone_number": "256-249-0028",
            "fax_number": "265-249-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDERFIELD",
        "first_name": "DEBORAH",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-21",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AL",
            "license": "1-113630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNP COLLABORATION LICENSE",
            "identifier": "1-113630",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESCRIBING NUMBER",
            "identifier": "3687",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANP CERTIFICATION",
            "identifier": "A0512010",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylacauga, AL

Sources for this page

Verify at the official NPI Registry.