Holly Retherford, RDN, LDN is a medicare enrolled "Dietitian, Registered" provider in Gibson City, Illinois. Her current practice location is
1120 N Melvin St, Gibson City, Illinois. You can reach out to her office (for appointments etc.) via phone at
(217) 784-2865.
Holly Retherford is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1689200750.
Healthcare Provider's Profile
| Full Name | Holly Retherford |
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| Gender | Female |
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| Speciality | Dietitian, Registered |
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| Location | 1120 N Melvin St, Gibson City, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1689200750
- Provider Enumeration Date: 03/20/2020
- Last Update Date: 10/30/2023
Medicare PECOS Information:
- PECOS PAC ID: 3678958600
- Enrollment ID: I20220912002820
Medical Identifiers
Medical identifiers for Holly Retherford such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1689200750 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Holly Retherford allows following entities to bill medicare on her behalf.
| Provider Name | Gibson Community Hospital Association |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1114935681 PECOS PAC ID: 5092703124 Enrollment ID: O20040505001293 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Holly Retherford is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Holly Retherford, RDN, LDN 1120 N Melvin St, Gibson City, IL 60936-1477 Ph: (217) 784-4251 | Holly Retherford, RDN, LDN 1120 N Melvin St, Gibson City, IL 60936-1477 Ph: (217) 784-2865 |
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