Kody Keith Holt, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Enterprise, Utah. His current practice location is
223 S. 200 E, Enterprise, Utah. You can reach out to his office (for appointments etc.) via phone at
(435) 878-2281.
Kody Keith Holt is licensed to practice in Utah (license number 9809369-4408) 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 1316533698.
Provider's Profile
| Full Name | Kody Keith Holt |
|---|
| Gender | Male |
|---|
| Speciality | Nurse Practitioner - Family |
|---|
| Location | 223 S. 200 E, Enterprise, Utah |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1316533698
- Provider Enumeration Date: 12/21/2020
- Last Update Date: 12/21/2020
Medicare PECOS Information:
- PECOS PAC ID: 1850781774
- Enrollment ID: I20211208003614
Medical Identifiers
Medical identifiers for Kody Keith Holt such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1316533698 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363LF0000X | Nurse Practitioner - Family | 9809369-4408 (Utah) | 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. Kody Keith Holt allows following entities to bill medicare on his behalf.
| Entity Name | Main Street Family Medicine Pllc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1518636844 PECOS PAC ID: 0547650962 Enrollment ID: O20211129001703 |
|---|
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. Kody Keith Holt 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 |
Kody Keith Holt, FNP-C 420 N 225 W, Po Box 758, Enterprise, UT 84725 Ph: () - | Kody Keith Holt, FNP-C 223 S. 200 E, Enterprise, UT 84725 Ph: (435) 878-2281 |
Reviews and Comments