Individual provider Active NPI

Karin Marie Lindholm, D.O.

  • Neurology Physician
  • Hailey, ID
National Provider Identifier
1083660583
Registry record updated Jan 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
O-159 Issued in ID
Practice address
1450 Aviation Dr
Suite 203
Hailey, ID 83333-8785
Phone
(208) 727-8295
NPI assigned
May 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X O-159 ID Primary

Addresses

Primary practice location

1450 Aviation Dr
Suite 203
Hailey, ID 83333-8785

Mailing address

821 Buckskin Dr
Hailey, ID 83333-8752
Phone (208) 788-0908

Other identifiers 5

IdentifierTypeStateIssuer
000010000939OtherIDREGENCE BLUE SHIELD ID
S2426OtherIDBLUE CROSS ID
002457400MedicaidID
353306900OtherIDOWCP ID
130025239OtherIDRAILROAD MEDICARE ID

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080220000673 ID Practitioner - Neurology 5193809705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Clinic - Wood River LLCGroup PAC ID 3173783818, 66 clinicians

Practice addresses (Care Compare)

100 Hospital Dr
Ketchum, ID 83340

100 Hospital Dr
Ketchum, ID 83340-9998

1450 Aviation Dr
Hailey, ID 83333-8785

191 5TH St W
Ketchum, ID 83340-9998
Phone (208) 725-2171

Hospital & facility affiliations

  • St Luke'S Wood River Medical Center Hospital, Ketchum, ID, CCN 131323
  • St Lukes Magic Valley Medical Center Hospital, Twin Falls, ID, CCN 130002
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006

Merit-based Incentive Payment System (MIPS)

Final score
86.05 of 100Reported as group
Quality
91.8
Promoting interoperability
100
Improvement activities
40
Cost
61.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic - Wood River LLC CurrentSince Oct 9, 2012 Accepting new patients
Mary E River MD PA Neurology Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

1450 Aviation Dr
Ste 203
Hailey, ID 83333
Phone (208) 727-8295

21 E Maple St
Ste A
Hailey, ID 83333
Phone (208) 788-3200

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359504000000",
    "number": "1083660583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 BUCKSKIN DR",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833338752",
            "telephone_number": "208-788-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 AVIATION DR",
            "address_2": "SUITE 203",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833338785",
            "telephone_number": "208-727-8295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDHOLM",
        "first_name": "KARIN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2013-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "ID",
            "license": "O-159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD ID",
            "identifier": "000010000939",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ID",
            "identifier": "S2426",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002457400",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP ID",
            "identifier": "353306900",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE ID",
            "identifier": "130025239",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hailey, ID

Sources for this page

Verify at the official NPI Registry.