RANDI MOORE HOLLIS (FNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1346642121
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
2,657 NURSE PRACTITIONER in UT
Provider Addresses for RANDI MOORE HOLLIS (FNP)
1220 E 3900 S STE 1F
SALT LAKE CITY, UT 841241327
Phone: (801) 262-5711
Type: Mailing
4052 W 3390 S
Ste 105
West Valley City, UT 84120
Phone: (801) 964-3111
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 18 Open Payments records for all available years, with a total value of $271.
Total Amount is formed as General ($271) + Research ($0) + Ownership ($0) = $271.
Last reported payment date: 2024-11-12 • Largest payer in this snapshot: ABBVIE INC. ($209).
Total Amount
$271
General + Research + Ownership
Payments
18
Total payment records
General Amount
$271
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $209 |
| Tris Pharma Inc | $36 |
| Hologic Sales and Service, LLC | $26 |
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: 2015-02-04
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 |
|---|---|---|---|---|
| I20150204000008 | I | Nurse Practitioner | UT | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 45 | 12 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 21 | 16 | $0 |
Insurance plans in this area (ZIP 84124)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | UT | |
| - | UT | |
| - | UT | |
| Clinical Social Worker | UT | |
| Clinical Social Worker | UT | |
| Nurse Practitioner | UT | |
| Clinical Social Worker | UT | |
| Nurse Practitioner | UT | |
| - | UT | |
| Clinical Social Worker | UT |
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