Kody Keith Holt, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Enterprise, Utah. He graduated from nursing school in 2020 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Revere Health Pc and 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
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1316533698.
Provider's Profile
| Full Name | Kody Keith Holt |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Experience | 6 Years |
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| Location | 223 S. 200 E, Enterprise, Utah |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Kody Keith Holt graduated from nursing school in 2020
NPI Data:
- NPI Number: 1316533698
- Provider Enumeration Date: 12/21/2020
- Last Update Date: 10/30/2025
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 |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
| Revere Health Pc | 7517868508 | 410 |
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 |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1518636844 PECOS PAC ID: 0547650962 Enrollment ID: O20211129001703 |
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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. 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 Po Box 758, Enterprise, UT 84725-0758 Ph: () - | Kody Keith Holt, FNP-C 223 S. 200 E, Enterprise, UT 84725 Ph: (435) 878-2281 |
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