Sandra J. Holmgren, GNP-C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

CNP1464 Issued in MN

Practice address

40520 County Highway 34
Ogema, MN 56569

Phone

(218) 983-4300

Fax

(218) 983-4300

NPI assigned

Apr 3, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Naytahwaush Health Center

  • Federal Public Health Clinic/Center
  • Mahnomen, MN
  • NPI 1740202308
  NPD
• Pine Point Health Station

  • Federal Public Health Clinic/Center
  • Ponsford, MN
  • NPI 1679587331
  NPD
• White Earth Indian Health Center

  • Federal Public Health Clinic/Center
  • Ogema, MN
  • NPI 1093761710
  NPD
• Center for Psychiatric Care

  • Psychiatry Physician
  • Grand Forks, ND
  • NPI 1043271885
  NPD (past)

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438732800000",
    "number": "1053677062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40520 COUNTY HIGHWAY 34",
            "city": "OGEMA",
            "state": "MN",
            "postal_code": "56569",
            "telephone_number": "218-983-4300",
            "fax_number": "218-983-6217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40520 COUNTY HIGHWAY 34",
            "city": "OGEMA",
            "state": "MN",
            "postal_code": "56569",
            "telephone_number": "218-983-4300",
            "fax_number": "218-983-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMGREN",
        "first_name": "SANDRA",
        "middle_name": "J.",
        "credential": "GNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-03",
        "last_updated": "2015-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "ND",
            "license": "R37463",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "CNP1464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053677062",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053677062",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053677062",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Makenna Hesch
• Howard Ho, OD
• Megan Hofland, RN BSN
• Doreen Lorraine Holding Eagle, MSW
• Stephen Edward Holmes, M.D.
• Brenda L Hoverson, RN
• Michael Igwe, DMD
• Toby Joe Imler Jr., DDS
• Steven W Jensen, PT
• David Emanuel Johnson, MD

• Gerontology Nurse Practitioner in Ogema, MN
• Providers in Ogema, MN by specialty
• Gerontology Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2015; 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.