HOLLY MARIE HENDERSHOT (APRN) – Family Nurse Practitioner, NPI 1083366397
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,105 NURSE PRACTITIONER in MI
Provider Addresses for HOLLY MARIE HENDERSHOT (APRN)
613 BROWN ST
SAINT CLAIR, MI 480794891
Phone: (810) 887-7858
Type: Mailing
2795 EDISON DR
MARYSVILLE, MI 480402068
Phone: (810) 300-6100
Type: Location
2795 Edison Dr
Marysville, MI 480402068
Phone: (810) 300-6100
Type: Location
28800 RYAN RD STE 320
WARREN, MI 480924272
Phone: (877) 906-9699
Fax: (866) 227-7418
Type: Location
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: 2022-11-14
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20221114002792 | I | Nurse Practitioner | MI | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 173 | 64 | $0 |
| 90792 | Psychiatric diagnostic evaluation with medical services | 135 | 133 | $0 |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 62 | 14 | $0 |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 41 | 22 | $0 |
| 90785 | Psychiatric services complicated by communication factor | 23 | 23 | $0 |
Insurance plans in this area (ZIP 48079)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | AR | |
| - | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | NY | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Physician Assistant | MI |
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