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MS. HOLLY LAVENDER FNP
NPI 1639535628
Nurse Practitioner - Family in Perry, GA

Active since January 07, 2016PECOS Enrolled
1016 KEITH DR, PERRY, GA 31069(478) 988-1515(478) 988-1550 Get Directions Write a Review

NPPES record last updated: January 7, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Ms. Holly Lavender Fnp NPPES

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

MS. HOLLY LAVENDER FNP (NPI 1639535628) is an individual family provider in Perry, Georgia, licensed in Georgia (RN184680) and active in the NPI registry since January 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639535628
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMS. HOLLY LAVENDERCredential: FNP
Location Address1016 KEITH DRPerry, GA 31069
Mailing Address1016 Keith DrPerry, GA 31069 · (478) 988-1515 · Fax (478) 988-1550
Phone(478) 988-1515
Fax(478) 988-1550
Sole ProprietorNo
Enumeration DateJanuary 7, 2016
✔ NPI 1639535628 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in GA · RN184680
1016 KEITH DR, Perry, GA 31069
Open in Google Maps ↗

Other Names 1

Former Name (1)Holly E Clements

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama 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)

Ms. Holly Lavender Fnp 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 Holly Lavender reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Privia Medical Group Of Georgia LLC
82 mi
Internal Medicine
101 YORKTOWN DR
Fayetteville, GA 30214
  • Reassigned Medicare billing, Georgia enrollment
  • 759 clinicians in this Medicare group
NPI 1013313857 (770) 460-4285

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 31069 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
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier21 claims21 services$4.32 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
3 suppliers20 claims20 services$205.37 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

SARAH COXWELL HARRIS FNP-C
Nurse Practitioner (Family)
1016 KEITH DR
PERRY, GA 31069
Houston County (478) 988-1515

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 Holly Lavender's NPI number?

The NPI number for Holly Lavender is 1639535628. It was assigned to this individual provider in the NPPES registry on January 7, 2016. The provider is also known as Holly E Clements.

Where is Holly Lavender located?

Holly Lavender practices at 1016 Keith Dr, Perry, GA 31069. The listed phone number is (478) 988-1515.

What is Holly Lavender's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Holly Lavender enrolled in Medicare?

Yes. Holly Lavender is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Holly Lavender's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Holly Lavender reassigns Medicare benefits to Privia Medical Group Of Georgia LLC (Fayetteville, GA). 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 Holly Lavender's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Holly Lavender accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list Holly Lavender 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 Holly Lavender was last updated on January 7, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.