Randi Moore Hollis, FNP - Medicare Nurse Practitioner in Salt Lake City, UT

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Randi Moore Hollis, FNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Salt Lake City, Utah. She graduated from nursing school in 2018 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Lotus Center Inc, Catholic Health Initiatives Colorado and her current practice location is 1220 E 3900 S Ste 1f, Salt Lake City, Utah. You can reach out to her office (for appointments etc.) via phone at (801) 262-5711.

Randi Moore Hollis is licensed to practice in Utah (license number 5038133-4405) and she also participates in the medicare program. She may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1346642121.

Contact Information

Randi Moore Hollis, FNP
1220 E 3900 S Ste 1f,
Salt Lake City, UT 84124-1327
(801) 262-5711
Not Available

Map and Direction




Provider's Profile

Full NameRandi Moore Hollis
GenderFemale
SpecialityNurse Practitioner
Experience6 Years
Location1220 E 3900 S Ste 1f, Salt Lake City, Utah
Accepts Medicare AssignmentsMay be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Randi Moore Hollis graduated from nursing school in 2018
  NPI Data:
  • NPI Number: 1346642121
  • Provider Enumeration Date: 09/23/2014
  • Last Update Date: 07/07/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 2769707256
  • Enrollment ID: I20150204000008

Medical Identifiers

Medical identifiers for Randi Moore Hollis such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1346642121NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner 5038133-4405 (Utah)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health 5038133-4405 (Utah)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Lotus Center Inc428492349111
Catholic Health Initiatives Colorado8022927342972

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Randi Moore Hollis allows following entities to bill medicare on her behalf.
Entity NamePhysician Group Of Utah Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1477676930
PECOS PAC ID: 8022032234
Enrollment ID: O20060113000886
Entity NameKaren W. Malm, Ph.d., P.c.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1871701656
PECOS PAC ID: 4284732835
Enrollment ID: O20070723000349
Entity NameUniversity Of Utah Behavioral Health Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1740688613
PECOS PAC ID: 9537483607
Enrollment ID: O20150120001118
Entity NameLotus Center Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1992167118
PECOS PAC ID: 4284923491
Enrollment ID: O20160511001262
Entity NameUniversity Of Utah Pediatric Acuity Care
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1619325131
PECOS PAC ID: 6406148345
Enrollment ID: O20160713000869
Entity NameUniversity Of Utah Pediatric Behavioral Health Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1649631599
PECOS PAC ID: 3870886898
Enrollment ID: O20160727002309
Entity NameCatholic Health Initiatives Colorado
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1942903562
PECOS PAC ID: 8022927342
Enrollment ID: O20230615001995

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Randi Moore Hollis is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Randi Moore Hollis, FNP
1220 E 3900 S Ste 1f,
Salt Lake City, UT 84124-1327

Ph: (801) 262-5711		Randi Moore Hollis, FNP
1220 E 3900 S Ste 1f,
Salt Lake City, UT 84124-1327

Ph: (801) 262-5711

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.