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SAMUEL LAWRENCE HOLLEY
NPI 1447719489
Psychiatry & Neurology - Psychiatry in Twin Falls, ID

Active since March 19, 2019PECOS Enrolled
815 N COLLEGE RD, TWIN FALLS, ID 83301(208) 814-9100(208) 814-9903 Get Directions Write a Review

NPPES record last updated: August 13, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 13, 2024, Mar 8, 2023, Mar 1, 2023 and 4 more (7 updates tracked since 2019).

About Samuel Lawrence Holley NPPES

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

SAMUEL LAWRENCE HOLLEY (NPI 1447719489) is an individual psychiatry provider in Twin Falls, Idaho, licensed in Idaho (O-2013) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1447719489
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameSAMUEL LAWRENCE HOLLEY
Location Address815 N COLLEGE RDTwin Falls, ID 83301-3484
Mailing Address190 E Bannock StBoise, ID 83712-6241
Phone(208) 814-9100
Fax(208) 814-9903
Sole ProprietorNo
Enumeration DateMarch 19, 2019
Last NPPES UpdateAugust 13, 20247 updates tracked since enumeration
NPPES CertifiedAugust 13, 2024
✔ NPI 1447719489 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
Licenses✔ Licensed in ID · O-2013✔ Licensed in WA · OP61406164
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Also ListedCounselorTaxonomy 101Y00000X · License CG61210477 (WA)
815 N COLLEGE RD, Twin Falls, ID 83301
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1101 W 8th AveSpokane, WA 99204-2307 · Phone (435) 253-1201
Location 2131 S Division StSpokane, WA 99202-1510 · Phone (509) 838-4651

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel Lawrence Holley 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.

Medicare Billing Reassignment

Medicare enrollment records show Samuel Holley reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

St Luke's Clinic LLC
1.8 mi
Family Medicine
775 POLE LINE RD W
Twin Falls, ID 83301
  • Reassigned Medicare billing, Idaho enrollment
  • Medicare enrollment name: St Lukes Clinic LLC
  • 322 clinicians in this Medicare group
NPI 1790718229 (208) 814-1000

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 83301 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
$160.17 typical visit price
range $52.44 – $160.17
Typical copayment $40.04 (range $13.11 – $40.04)
Most-billed visit code 99205
Established Patient
$65.77 typical visit price
range $16.68 – $130.93
Typical copayment $16.44 (range $4.17 – $32.73)
Most-billed visit code 99213
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 16

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

MADISON CHRISTINE CAMPBELL MSN, APRN, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
815 N COLLEGE RD
TWIN FALLS, ID 83301
Twin Falls County (208) 814-9100
MS. STACEY HALLMARK LMSW
Social Worker (Clinical)
815 N COLLEGE RD
TWIN FALLS, ID 83301
Twin Falls County (208) 814-9100
TRAVIS PEHRSON APRN-CNP
Nurse Practitioner (Psychiatric/Mental Health)
815 N COLLEGE RD
TWIN FALLS, ID 83301
Twin Falls County (208) 814-9100
CHRISTOPHER ROBIN DENHAM MD
Psychiatry & Neurology (Psychiatry)
815 N COLLEGE RD
TWIN FALLS, ID 83301
Twin Falls County (208) 814-9100
DR. KELSEY N SILVESTER DO
Psychiatry & Neurology (Psychiatry)
815 N COLLEGE RD
TWIN FALLS, ID 83301
Twin Falls County (208) 814-9100
DR. MIRANDA L HIGHAM PHD
Psychologist
815 N COLLEGE RD
TWIN FALLS, ID 83301
Twin Falls County (208) 814-9100
REENA M CAMOENS MD
Psychiatry & Neurology (Psychiatry)
815 N COLLEGE RD
TWIN FALLS, ID 83301
Twin Falls County (208) 814-9100
PATRICIA KRISAR WHITE M.D.
Psychiatry & Neurology (Psychiatry)
815 N COLLEGE RD
TWIN FALLS, ID 83301
Twin Falls County (208) 814-9100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel Holley's NPI number?

The NPI number for Samuel Holley is 1447719489. It was assigned to this individual provider in the NPPES registry on March 19, 2019.

Where is Samuel Holley located?

Samuel Holley practices at 815 N College Rd, Twin Falls, ID 83301. The listed phone number is (208) 814-9100.

What is Samuel Holley's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Samuel Holley enrolled in Medicare?

Yes. Samuel Holley is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Samuel Holley's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Holley reassigns Medicare benefits to St Luke's Clinic LLC (Twin Falls, ID). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samuel Holley's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Samuel Holley accept?

Health plans from Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Select Health list Samuel Holley as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Samuel Holley was last updated on August 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.