Mary Pat Holler-Bibel, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R26553 Issued in ND

Practice address

718 Oak St
Grand Forks, ND 58201-4460

Phone

(218) 230-0070

Fax

(800) 958-7702

NPI assigned

Apr 26, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Center for Psychiatric Care

  • Psychiatry Physician
  • Grand Forks, ND
  • NPI 1043271885
  NPD (past)
• Upper Mississippi Mental Health Center, Inc

  • Community/Behavioral Health Agency
  • Bemidji, MN
  • NPI 1083717334
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1023075975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 PEARL RD STE C1",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441363349",
            "telephone_number": "440-268-8422",
            "fax_number": "440-268-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 OAK ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014460",
            "telephone_number": "218-230-0070",
            "fax_number": "800-958-7702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3593 Medina Rd Ste 181",
            "address_purpose": "LOCATION",
            "city": "Medina",
            "state": "OH",
            "postal_code": "442568182",
            "country_code": "US",
            "telephone_number": "330-536-3746",
            "fax_number": "888-204-5174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3593 Medina Rd Ste 181",
            "address_purpose": "LOCATION",
            "city": "Medina",
            "state": "OH",
            "postal_code": "442568182",
            "country_code": "US",
            "telephone_number": "330-536-3746",
            "fax_number": "888-204-5174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "902 N Orange St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598022928",
            "country_code": "US",
            "telephone_number": "406-327-3362",
            "fax_number": "406-327-3349",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10900 Pearl Rd Ste C1",
            "address_purpose": "LOCATION",
            "city": "Strongsville",
            "state": "OH",
            "postal_code": "44136",
            "country_code": "US",
            "telephone_number": "440-268-8422",
            "fax_number": "440-268-8422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLER-BIBEL",
        "first_name": "MARY PAT",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "NP1338690",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "MN",
            "license": "2010011783",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "MT",
            "license": "NUR-APRN-LIC-153741",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R26553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BC/BS",
            "identifier": "68D22CE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ND BC/BS",
            "identifier": "17981",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "50000686",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "604715700",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HE1472284",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsay Hoffmann
• Erica Lea Hoffner
• Bernard Jerome Hoggarth, MD
• Lucas Holkup, MD
• Nicholas Holkup, DPT
• Jennavive Marie Holm, OTD
• Karena Lee Holm, PT
• Kenzie Holm
• Scott Holm, DPT
• Tyson Thomas Holm, MD

• All providers in Grand Forks, ND
• Family Nurse Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.