SERENITYPASS HOLISTIC HEALTH PLLC
NPI 1639935281
Nurse Practitioner - Family in Sandoval, IL
About Serenitypass Holistic Health Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SERENITYPASS HOLISTIC HEALTH PLLC (NPI 1639935281) is a healthcare organization registered as a family in Sandoval, Illinois and active in the NPI registry since February 2024. The organization maintains a secondary practice location in Odin and lists Kelly Hall, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Serenitypass Holistic Health Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Serenitypass Holistic Health PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Serenitypass Holistic Health PLLC's NPI number?
The NPI number for Serenitypass Holistic Health PLLC is 1639935281. It was assigned to this organization in the NPPES registry on February 22, 2024.
Where is Serenitypass Holistic Health PLLC located?
Serenitypass Holistic Health PLLC is located at 605 N Mine St, Sandoval, IL 62882. The listed phone number is (618) 552-3034.
What is Serenitypass Holistic Health PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Serenitypass Holistic Health PLLC enrolled in Medicare?
Yes. Serenitypass Holistic Health PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Serenitypass Holistic Health PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Serenitypass Holistic Health PLLC. A 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 the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Serenitypass Holistic Health PLLC was last updated on December 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.
# Serenitypass Holistic Health Pllc · NPI 1639935281
Family organization in Sandoval, Illinois. Organization record, active in the CMS NPPES registry since February 22, 2024.
## Identity
- **NPI:** 1639935281 (Entity type: Organization)
- **Enumerated:** February 22, 2024
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Kelly Hall, OWNER
## Practice location
- **Address:** 605 N MINE ST, Sandoval, IL 62882-1103
- **Phone:** (618) 552-3034
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 16, 2024
---
Source: [NPI Profile](https://npiprofile.com/npi/1639935281) · Data from the CMS NPPES public registry.