Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

HOLLY MCCLURE AGNP-C
NPI 1023424348
Nurse Practitioner in Santa Rosa, CA

Q: What is Holly Mcclure's NPI number?

The NPI number for Holly Mcclure is 1023424348. It was assigned to this individual provider in the NPPES registry on July 8, 2014. The provider is also known as Holly Shumard.

Q: What is Holly Mcclure's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Holly Mcclure was last updated on October 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 08, 2014PECOS Enrolled

220 CONCOURSE BLVD, SANTA ROSA, CA 95403(844) 527-7369(844) 847-4943 Get Directions Write a Review

NPPES record last updated: October 30, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 30, 2026, Mar 10, 2025 (2 updates tracked since 2025).

On this page

About Holly Mcclure Agnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HOLLY MCCLURE AGNP-C (NPI 1023424348) is an individual nurse practitioner in Santa Rosa, California, licensed in California (95032617) and active in the NPI registry since July 2014. She is enrolled in Medicare PECOS, maintains a secondary practice location in Lakeport, and is a graduate of University Of Massachusetts Medical School (2014).

NPPES Registry Identity

NPI1023424348

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameHOLLY MCCLURECredential: AGNP-C

Location Address220 CONCOURSE BLVDSanta Rosa, CA 95403-8210

Mailing Address220 Concourse BlvdSanta Rosa, CA 95403-8210 · (844) 527-7369 · Fax (844) 847-4943

Phone(844) 527-7369

Fax(844) 847-4943

Sole ProprietorNo

Medical School CMSUniversity Of Massachusetts Medical SchoolGraduated 2014

Enumeration DateJuly 8, 2014

Last NPPES UpdateOctober 30, 20262 updates tracked since enumeration

NPPES CertifiedOctober 30, 2026

✔ NPI 1023424348 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in CA · 95032617

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

220 CONCOURSE BLVD, Santa Rosa, CA 95403

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Other Names 1

Former Name (1)Holly Shumard

Secondary Practice Location 1

Location 15150 Hill Rd E Ste CLakeport, CA 95453-5100 · Phone (844) 527-7369 · Fax (844) 847-4943

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Holly Mcclure Agnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6608399696

PECOS Enrollment IDI20250331002986

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Holly Mcclure reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Evolve Restorative Center

Same address

Interventional Pain Medicine

220 CONCOURSE BLVD
Santa Rosa, CA 95403

Reassigned Medicare billing, California enrollment
9 clinicians in this Medicare group

NPI 1215437249 (844) 527-7369

Rocky Mountain Kidney Care PC

72 mi

Nephrology

2000 S EL CAMINO REAL FL 1
San Mateo, CA 94403

Reassigned Medicare billing, California enrollment
6 clinicians in this Medicare group

NPI 1316761943 (888) 288-5977

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95403 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.16 typical visit price

range $63.04 – $187.01

Typical copayment $24.04 (range $15.76 – $46.75)

Most-billed visit code 99203

Established Patient

$109.88 typical visit price

range $21.02 – $153.40

Typical copayment $27.47 (range $5.25 – $38.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JULIE BARLOW ACNP-BC

Nurse Practitioner (Acute Care)