Keith Holley, FNP-C is a medicare enrolled "Nurse Practitioner - Family" physician in Hendersonville, Tennessee. His current practice location is
353 New Shackle Island Rd Ste 140c, Hendersonville, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(615) 826-5664.
Keith Holley is licensed to practice in Tennessee (license number 34210) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1992483903.
Physician's Profile
Full Name | Keith Holley |
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Gender | Male |
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Speciality | Nurse Practitioner - Family |
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Location | 353 New Shackle Island Rd Ste 140c, Hendersonville, Tennessee |
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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: 1992483903
- Provider Enumeration Date: 07/10/2023
- Last Update Date: 06/25/2025
Medicare PECOS Information:
- PECOS PAC ID: 6406391325
- Enrollment ID: I20240715003248
Medical Identifiers
Medical identifiers for Keith Holley such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1992483903 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 34210 (Tennessee) | Secondary |
363LF0000X | Nurse Practitioner - Family | 34210 (Tennessee) | 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. Keith Holley allows following entities to bill medicare on his behalf.
Entity Name | Advanced Diagnostic Imaging Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1093741464 PECOS PAC ID: 7315848140 Enrollment ID: O20040115000677 |
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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. Keith Holley 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 |
Keith Holley, FNP-C 123 Trail Ridge Way, Hendersonville, TN 37075-2190 Ph: () - | Keith Holley, FNP-C 353 New Shackle Island Rd Ste 140c, Hendersonville, TN 37075-2366 Ph: (615) 826-5664 |
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