Holly Haberman
Individual provider Active NPI Family Nurse Practitioner · Yankton, SD
NPI 1083073597 · NPPES record last updated Feb 12, 2016
Key facts
- NPI
- 1083073597
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- XXXXX (NE)
- Practice address
- 409 Summit St
Suite # 3400
Yankton, SD 57078-3734 - Phone
- (605) 260-0310
- NPI assigned
- Feb 12, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 20
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sacred Heart Health Services
Practice addresses (Care Compare)
2525 Fox Run Pkwy
Yankton, SD 57078-5371
501 Summit St
Yankton, SD 57078-3855
Phone (605) 668-8795
Hospital & facility affiliations
- Avera Sacred Heart Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161222000371 | SD | Practitioner - Nurse Practitioner | 3173802733 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| XXXXX | NE | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sacred Heart Health Services | Current |
Accepting new patients | |
| Sacred Heart Health Services | Current |
Accepting new patients | |
| Sacred Heart Health Services | Current | Accepting new patients | |
| Union County Health Foundation | Past | Accepting new patients |
Locations
2525 Fox Run Pkwy
Ste 200
Yankton, SD 57078
Phone (605) 260-2100
501 Summit St
Yankton, SD 57078
Phone (605) 655-1201
409 Summit St
Ste 3400
Yankton, SD 57078
Phone (605) 260-0310
Interoperability endpoints
- holly.haberman@avera.sdhealthlink.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | XXXXX | NE | Yes |
Addresses
Primary practice location
409 Summit St
Suite # 3400
Yankton, SD 57078-3734
Mailing address
55149 Knox Ave
Crofton, NE 68730-4144
Phone (402) 388-2374
Other providers in Yankton, SD
- Greentree Psychological Services, P.C.
- Robin Curtiss Grossenburg
- John Gullikson
- Steve Gutnik
- Annette Haberman
- Katelyn Haiar
- Rachel Lynn Hajek
- Lina M. Hall
- Colin Hanna
- Lori A Hansen
All providers in Yankton, SD · Family Nurse Practitioner in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.