Jack Holland, CRNA - Medicare Nurse Anesthetist, Certified Registered in Heber City, UT

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Jack Holland, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Heber City, Utah. His current practice location is Heber Valley Hospital, 1485 Us-40, Heber City, Utah. You can reach out to his office (for appointments etc.) via phone at (435) 654-2500.

Jack Holland is licensed to practice in Utah (license number 9809402-4406) 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 1699755231.

Contact Information

Jack Holland, CRNA
Heber Valley Hospital, 1485 Us-40,
Heber City, UT 84032
(435) 654-2500
Not Available

Map and Direction




Provider's Profile

Full NameJack Holland
GenderMale
SpecialityNurse Anesthetist, Certified Registered
LocationHeber Valley Hospital, Heber City, Utah
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1699755231
  • Provider Enumeration Date: 01/19/2006
  • Last Update Date: 10/26/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 8224134408
  • Enrollment ID: I20180507002417

Medical Identifiers

Medical identifiers for Jack Holland such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1699755231NPI-NPPES
8051521MedicaidNC

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered 821399 (Nevada)Secondary
367500000XNurse Anesthetist, Certified Registered 9809402-4406 (Utah)Primary
367500000XNurse Anesthetist, Certified Registered 053081 (North Carolina)Secondary
163W00000XRegistered Nurse 161328 (North Carolina)Secondary

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. Jack Holland allows following entities to bill medicare on his behalf.
Entity NameLegacy Anesthesia LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1851764112
PECOS PAC ID: 9234438649
Enrollment ID: O20160505001075

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. Jack Holland 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 AddressPractice Location Address
Jack Holland, CRNA
6127 Kingsford Ave,
Park City, UT 84098-6317

Ph: (307) 203-7739		Jack Holland, CRNA
Heber Valley Hospital, 1485 Us-40,
Heber City, UT 84032

Ph: (435) 654-2500

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Heber City, UT

Mr. Justin Douglas Wiliiams, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 454 E Medical Way, Heber City, UT 84032
Phone: 435-658-6738    
Michael A Dagley, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 1485 S Highway 40, Heber City, UT 84032
Phone: 435-654-2500    
Shannon H Hallowell-schemmer, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 1485 S Highway 40, Heber City, UT 84032
Phone: 435-654-2500    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.