Holly Lynn Nikodym, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95025306 Issued in CA

Practice address

901 San Bernardino Rd Ste 300
Upland, CA 91786-7299

Phone

(909) 579-6753

NPI assigned

May 23, 2023

Last updated

May 23, 2023By the provider in NPPES

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 CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grobler Enterprises IncGroup PAC ID 7012060189, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grobler Enterprises Inc

  dba Central Medical Group

  • Internal Medicine Physician
  • Upland, CA
  • NPI 1841430535
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1083306542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 SAN BERNARDINO RD STE 300",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917867299",
            "telephone_number": "909-579-6753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SAN BERNARDINO RD STE 300",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917867299",
            "telephone_number": "909-579-6753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKODYM",
        "first_name": "HOLLY",
        "middle_name": "LYNN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-23",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95025306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicolas Transito DDS, Inc (Lupita Quality Dental)
• Nicole Kohan, O.D., Inc. (Mountain Eyes Optometric Center)
• Jessica Nicolle
• Nigoghosian & Nigoghosian DDS Inc
• Siavash Nikkhou, DC., MS., QME
• Nina Chan, M.D., Inc
• Russel Rovira Nolasco, DDS
• Norina Murphy MSW, LCSW & Associates
• Tiffany Marie Norris
• North Star Psychological Services P.C.

• Family Nurse Practitioner in Upland, CA
• Providers in Upland, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.