Individual provider Active NPI

Preston Thomas Holifield, FNP-C

  • Family Nurse Practitioner
  • Cape Girardeau, MO
National Provider Identifier
1982397436
Registry record updated Apr 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2023019957 Issued in MO
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

Updated by the provider on Apr 11, 2026

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 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

IdentifierTypeStateIssuer
420124427MedicaidMO

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 Hospital, Cape Girardeau, MO, CCN 260183

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ste Genevieve County Memorial Hospital Current Accepting new patients
Analytical Pathology Services LTD Current Accepting new patients
Southeast Missouri Hospital Physicians, LLC CurrentSince Jun 5, 2023 Accepting new patients
Ste Genevieve County Memorial Hospital CurrentSince Sep 26, 2023 Accepting new patients
Guardian Primary Care LLC CurrentSince Dec 26, 2024 Accepting new patients
Ste Genevieve County Memorial Hospital CurrentSince Sep 26, 2023 Accepting new patients
Ste Genevieve County Memorial Hospital Current Accepting new patients
Signify Health, LLC CurrentSince Jul 31, 2023 Accepting new patients
Southeast Hospital PastSince Jun 4, 2023 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.

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

Verify at the official NPI Registry.