Katie Marie Buchholz, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3315-35 Issued in WI

Practice address

4801 Expo Dr
Manitowoc, WI 54220-9341

Phone

(920) 684-4429

Fax

(920) 684-6892

NPI assigned

Jul 23, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Eye Clinic of Manitowoc, S.C.

  • Ophthalmology Physician
  • Manitowoc, WI
  • NPI 1437144417

  Optometrist

  NPD (past)
• Two Rivers Eye Clinic

  • Ophthalmology Physician
  • Two Rivers, WI
  • NPI 1114084324

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1043652720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 W SILVER SPRING DR",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174922",
            "telephone_number": "414-961-6000",
            "fax_number": "847-832-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 EXPO DR",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542209341",
            "telephone_number": "920-684-4429",
            "fax_number": "920-684-6892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHHOLZ",
        "first_name": "KATIE",
        "middle_name": "MARIE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3315-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emilie Brienen, M.S. CCC-SLP
• Heather Marie Bruckschen, LPC, CSAC
• Brittany Nicole Bryan
• Abbey Bubolz, RD
• Victoria Bubolz
• Donna Buechner, NPC
• Jon W Buggs, CRNA
• April Marie Buhr, RDH
• Daniel Joseph Burbach, PHD
• Anna Burch

• Optometrist in Manitowoc, WI
• Providers in Manitowoc, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.