Active NPI
Preston Thomas Holifield, FNP-C
- Family Nurse Practitioner
- Cape Girardeau, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2023019957
- Practice address
- 2441 Myra Dr
Cape Girardeau, MO 63703-5803 - Phone
- (573) 200-6143
- Fax
- (573) 755-0706
- NPI assigned
- May 31, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2023019957 | MO | Primary |
Addresses
Primary practice location
2441 Myra Dr
Cape Girardeau, MO 63703-5803
Mailing address
2441 Myra Dr
Cape Girardeau, MO 63703-5803
Phone (573) 200-6143
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 420124427 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230629001269 | MO | Practitioner - Nurse Practitioner | 7517326192 | Reassigns benefits to 6 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2441 Myra Dr
Cape Girardeau, MO 63703-5803
Phone (573) 200-6390
Hospital & facility affiliations
- Saint Francis Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ste Genevieve County Memorial Hospital | Current | Accepting new patients | |
| Analytical Pathology Services LTD | Current | Accepting new patients | |
| Southeast Missouri Hospital Physicians, LLC | Current | Accepting new patients | |
| Ste Genevieve County Memorial Hospital | Current | Accepting new patients | |
| Guardian Primary Care LLC | Current | Accepting new patients | |
| Ste Genevieve County Memorial Hospital | Current | Accepting new patients | |
| Ste Genevieve County Memorial Hospital | Current | Accepting new patients | |
| Signify Health, LLC | Current | Accepting new patients | |
| Southeast Hospital | Past | Accepting new patients |
Locations
255 Boderman
Bloomsdale, MO 63627
Phone (573) 483-2727
1420 Kurre Ln
Cape Girardeau, MO 63701
Phone (573) 200-6390
2441 Myra Dr
Cpe Girardeau, MO 63703
Phone (573) 200-6390
1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822
611 W Main St
Fredericktown, MO 63645
Phone (573) 773-7061
2432 E Main St
Jackson, MO 63755
Phone (573) 334-4822
2300 Main St
Fl 9
Kansas City, MO 64108
Phone (800) 416-1767
800 Ste Genevieve Dr
Ste Genevieve, MO 63670
Phone (573) 883-2571
753 Pointe Basse Dr
Ste Genevieve, MO 63670
Phone (573) 883-2782
120 Plaza Dr
Ste Genevieve, MO 63670
Phone (573) 883-1199
590 Pine Dr
Ste Genevieve, MO 63670
Phone (573) 883-4455
575 Pine Dr
Ste Genevieve, MO 63670
Phone (573) 883-7424
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Organizations & group practices 9
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.
-
- Family Medicine Physician
- Cape Girardeau, MO
- NPI 1558311522
MO
-
- Rural Health Clinic/Center
- Ste Genevieve, MO
- NPI 1801817416
MO
-
- Anatomic Pathology & Clinical Pathology Physician
- Saint Louis, MO
- NPI 1558343673
-
- Hospitalist Physician
- Ste Genevieve, MO
- NPI 1811318322
-
- Community/Retail Pharmacy
- Cape Girardeau, MO
- NPI 1336150846
Hospital & facility affiliations 2
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": "1685491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775865600000",
"number": "1982397436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2441 MYRA DR",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "637035803",
"telephone_number": "573-200-6143",
"fax_number": "573-755-0706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2441 MYRA DR",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "637035803",
"telephone_number": "573-200-6143",
"fax_number": "573-755-0706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLIFIELD",
"first_name": "PRESTON",
"middle_name": "THOMAS",
"name_prefix": "Mr.",
"credential": "FNP-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-31",
"last_updated": "2026-04-11",
"certification_date": "2026-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MO",
"license": "2023019957",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "420124427",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cape Girardeau, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.