Individual provider Active NPI

Virginia Holmgren, PMHNP

  • Nurse Practitioner
  • Caldwell, ID
National Provider Identifier
1083598890
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4971965 Issued in ID
Practice address
808 Cleveland Blvd
Caldwell, ID 83605-4168
Phone
(208) 459-1025
Fax
(208) 466-5359
NPI assigned
Aug 4, 2025
Last updated
Aug 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4971965 ID Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4971965 ID

Addresses

Primary practice location

808 Cleveland Blvd
Caldwell, ID 83605-4168

Mailing address

PO Box 9
Nampa, ID 83653-0009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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

Enrollment IDStateProvider typePAC IDDetails
I20250826004458 ID Practitioner - Nurse Practitioner 2365942984 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Clinics IncGroup PAC ID 4082527353, 75 clinicians

Practice addresses (Care Compare)

300 S 23Rd St
Boise, ID 83702-9100
Phone (208) 344-3512

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4971965IDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Clinics, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Community Health Clinics, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Community Health Clinics, Inc. Nurse Practitioner Current Accepting new patients
Community Health Clinics, Inc. Past Accepting new patients

Locations

150 2nd St
Melba, ID 83641
Phone (208) 495-1011

3115 E Florence Dr
Meridian, ID 83642
Phone (208) 378-4288

211 16th Ave N
Nampa, ID 83687
Phone (208) 461-7149

Interoperability endpoints

  • Direct secure messaging: vholmgren355550@direct.ochin.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1754265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1083598890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836530009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 CLEVELAND BLVD",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054168",
            "telephone_number": "208-459-1025",
            "fax_number": "208-466-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMGREN",
        "first_name": "VIRGINIA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-04",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "4971965",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "4971965",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

Verify at the official NPI Registry.