HOLLY MCCLURE (NP) – Gerontology Nurse Practitioner, NPI 1023424348

HOLLY MCCLURE (NP) is a healthcare provider. based in Rohnert park, California. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 95393416 (CA). The NPI Number for HOLLY MCCLURE (NP) is 1023424348

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
HOLLY MCCLURE (NP)
NPI
1023424348
Phone
(707) 615-3347
Address
5789 STATE FARM DR STE 110
Enumeration Date
8 July 2014
Last Update Date
10 March 2025

Doctor Profile

Medical School Name
UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL
Secondary Phone
7206960852
Graduation Year
2014 (12 years ago)
PAC ID
6608399696
Group Practice PAC ID
4082144639
Professional Enrollment ID
I20250331002986
Address ID
CA944031805SA2000XREAL501
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness75
Years active:11State licenses:2Digital endpointsOther names

16,360 NURSE PRACTITIONER in CA

Provider Addresses for HOLLY MCCLURE (NP)

  • 5789 STATE FARM DR STE 110

    ROHNERT PARK, CA 949286308

    Phone: (707) 615-3347

    Type: Location

  • 88 MASONIC HOME RD

    CHARLTON, MA 015071394

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-03-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250331002986INurse PractitionerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 94928)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082144639View full group profile
NameSpecialtyState
Nurse PractitionerHI

Reviews

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Frequently asked questions

Is HOLLY MCCLURE (NP) listed with a National Provider Identifier?
Yes — HOLLY MCCLURE (NP) has NPI 1023424348 on file in the registry.
Is HOLLY MCCLURE (NP) still an active registrant?
HOLLY MCCLURE (NP) carries an active NPI according to the public dataset.
What area of care is associated with HOLLY MCCLURE (NP)?
HOLLY MCCLURE (NP)'s record emphasizes Gerontology Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in California is HOLLY MCCLURE (NP) registered?
Use Rohnert Park, California as the headline location for HOLLY MCCLURE (NP) here.
When was this NPI issued?
Enumeration for HOLLY MCCLURE (NP) is noted as July 8, 2014 where the registry provides it.

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