Active NPI
Laine Holcomb, PHARMD
- Pharmacist
- Otsego, MN
National Provider Identifier
1053946251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 123407
- Practice address
- 15800 87TH St NE
Otsego, MN 55330-6546 - Phone
- (763) 252-1316
- NPI assigned
- Mar 8, 2020
- Last updated
- Mar 8, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 123407 | MN | Primary |
Addresses
Primary practice location
15800 87TH St NE
Otsego, MN 55330-6546
Mailing address
13285 Granstrom Cir
Dayton, MN 55327-2005
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 123407 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583625600000",
"number": "1053946251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13285 GRANSTROM CIR",
"city": "DAYTON",
"state": "MN",
"postal_code": "553272005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15800 87TH ST NE",
"city": "OTSEGO",
"state": "MN",
"postal_code": "553306546",
"telephone_number": "763-252-1316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLCOMB",
"first_name": "LAINE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-08",
"last_updated": "2020-03-08",
"certification_date": "2020-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "123407",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Otsego, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.