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

KAILEY VICTORIA HOLM
NPI 1902647241
Physician Assistant - Medical in Surprise, AZ

Q: What is Kailey Holm's NPI number?

The NPI number for Kailey Holm is 1902647241. It was assigned to this individual provider in the NPPES registry on June 3, 2024.

Q: What is Kailey Holm's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Kailey Holm was last updated on August 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 37 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 June 03, 2024PECOS Enrolled

14961 W BELL RD STE 175, SURPRISE, AZ 85374(623) 547-7205 Get Directions Write a Review

NPPES record last updated: August 4, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Aug 4, 2026, Jun 3, 2024 (2 updates tracked since 2024).

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About Kailey Victoria Holm NPPES

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

KAILEY VICTORIA HOLM (NPI 1902647241) is an individual medical provider in Surprise, Arizona, licensed in Arizona (11411) and active in the NPI registry since June 2024. She is enrolled in Medicare PECOS and maintains a secondary practice location in Phoenix.

NPPES Registry Identity

NPI1902647241

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameKAILEY VICTORIA HOLM

Location Address14961 W BELL RD STE 175Surprise, AZ 85374-3220

Mailing Address14961 W Bell Rd Ste 175Surprise, AZ 85374-3220 · (623) 547-7205

Phone(623) 547-7205

Sole ProprietorYes

Enumeration DateJune 3, 2024

Last NPPES UpdateAugust 4, 20262 updates tracked since enumeration

NPPES CertifiedAugust 4, 2026

✔ NPI 1902647241 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in AZ · 11411

Also ListedPhysician AssistantTaxonomy 363A00000X · License 11411 (AZ)

14961 W BELL RD STE 175, Surprise, AZ 85374

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Secondary Practice Location 1

Location 1500 W Thomas Rd Ste 700Phoenix, AZ 85013-4295 · Phone (602) 406-7048 · Fax (602) 406-7650

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kailey Victoria Holm 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.

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.

ZEYAD ALSAEEDI MD

Internal Medicine