MR. WILLIAM GASTON HOLYFIELD IV CPNP-AC/PC
NPI 1093245755
Nurse Practitioner - Pediatrics in Jackson, MS

Q: What is William Holyfield's NPI number?

The NPI number for William Holyfield is 1093245755. It was assigned to this individual provider in the NPPES registry on June 15, 2017.

Q: What is William Holyfield's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for William Holyfield was last updated on June 15, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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 June 15, 2017PECOS Enrolled

2500 N STATE ST, JACKSON, MS 39216(601) 984-2001 Get Directions Write a Review

NPPES record last updated: June 15, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mr. William Gaston Holyfield Iv Cpnp-ac/pc NPPES

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

MR. WILLIAM GASTON HOLYFIELD IV CPNP-AC/PC (NPI 1093245755) is an individual pediatrics provider in Jackson, Mississippi, licensed in Mississippi (902064) and active in the NPI registry since June 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093245755

Entity TypeIndividualMale

Primary Taxonomy363LP0200X

Provider Legal NameMR. WILLIAM GASTON HOLYFIELD IVCredential: CPNP-AC/PC

Location Address2500 N STATE STJackson, MS 39216-4500

Mailing Address1175 Star RdBrandon, MS 39042-8423

Phone(601) 984-2001

Sole ProprietorNo

Enumeration DateJune 15, 2017

✔ NPI 1093245755 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in MS · 902064

2500 N STATE ST, Jackson, MS 39216

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. William Gaston Holyfield Iv Cpnp-ac/pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39216 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

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$92.20 typical visit price

range $16.15 – $129.61

Typical copayment $23.05 (range $4.03 – $32.40)

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.

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Other Providers at the Same Location NPPES 20

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

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