Patrice Holly, CRNA in Jefferson City, MO - Medicare Nurse Anesthetist, Certified Registered

Patrice Holly, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Jefferson City, Missouri. Her current practice location is 1125 Madison St, Jefferson City, Missouri. You can reach out to her office (for appointments etc.) via phone at (573) 632-5000.

Patrice Holly is licensed to practice in Missouri (license number 2023031634) 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 1295276376.

Contact Information

	Patrice Holly, CRNA
	1125 Madison St, Jefferson City, MO 65101-5227
	(573) 632-5000
	(573) 632-5876

Map and Direction

Provider's Profile

Full Name	Patrice Holly
Gender	Female
Speciality	Nurse Anesthetist, Certified Registered
Location	1125 Madison St, Jefferson City, Missouri
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1295276376
Provider Enumeration Date: 03/09/2017
Last Update Date: 05/15/2025

Medicare PECOS Information:

PECOS PAC ID: 5092080507
Enrollment ID: I20171010001905

Medical Identifiers

Medical identifiers for Patrice Holly such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1295276376	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	169433 (Tennessee)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	15753-33 (Wisconsin)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	23071 (Tennessee)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	2023031634 (Missouri)	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. Patrice Holly allows following entities to bill medicare on her behalf.

Entity Name	American Anesthesiology Of Tennessee Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1609822998 PECOS PAC ID: 9931001922 Enrollment ID: O20040713001364

Entity Name	Medical Anesthesia Group, Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1679527501 PECOS PAC ID: 9436047685 Enrollment ID: O20040726000882

Entity Name	Ut Regional One Physicians Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1093130585 PECOS PAC ID: 5698993418 Enrollment ID: O20140820000662

Entity Name	Resource Anesthesiology Associates Of Tn Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1316724073 PECOS PAC ID: 8527419092 Enrollment ID: O20240109002456

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. Patrice Holly 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
Patrice Holly, CRNA 6060 Primacy Pkwy, Suite 241, Memphis, TN 38119-5745 Ph: (901) 725-5846	Patrice Holly, CRNA 1125 Madison St, Jefferson City, MO 65101-5227 Ph: (573) 632-5000

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Jefferson City, MO

John G Charbonneau, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1445 Christy Dr, Jefferson City, MO 65101 Phone: 573-636-3483 Fax: 573-636-5315
Carl G. Bone, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1445 Christy Dr, Jefferson City, MO 65101 Phone: 573-636-3483 Fax: 573-636-5315
Mrs. Lana Elaine Wanstreet, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1125 Madison St, Jefferson City, MO 65101 Phone: 573-632-5000 Fax: 573-634-2033
Larry D. Winegar, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1445 Christy Dr, Jefferson City, MO 65101 Phone: 573-636-3483 Fax: 573-636-5315
Hanna Jo Findley, CRNA Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 2505 Mission Dr, Jefferson City, MO 65109 Phone: 573-636-3483 Fax: 573-636-3386
Eric K. Hale, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1445 Christy Dr, Jefferson City, MO 65101 Phone: 573-636-3483 Fax: 573-636-5315
Zane Noel Hartgraves, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2505 Mission Dr, Jefferson City, MO 65109 Phone: 573-636-3483 Fax: 573-636-3386

Patrice Holly, CRNA - Medicare Nurse Anesthetist, Certified Registered in Jefferson City, MO