Individual provider Active NPI

Holly Janette Martinchek

  • Acute Care Nurse Practitioner
  • Hancock, MI
National Provider Identifier
1093585820
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704278280 Issued in MI
Practice address
500 Campus Dr
Hancock, MI 49930-1452
Phone
(906) 483-1000
NPI assigned
Jan 3, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2100X 4704278280 MI Primary

Addresses

Primary practice location

500 Campus Dr
Hancock, MI 49930-1452

Mailing address

500 Campus Dr
Hancock, MI 49930-1452

Other names 1

  • Holly Janette Watkins Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240403000959 MI Practitioner - Nurse Practitioner 6507204096 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Central MichiganGroup PAC ID 6103733092, 183 clinicians

Practice addresses (Care Compare)

560 W Mitchell St
Suite 340
Petoskey, MI 49770-2277
Phone (231) 487-3182

Hospital & facility affiliations

  • McLaren Northern Michigan Hospital, Petoskey, MI, CCN 230105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704278280MIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Portage Physician Practices Inc Single Specialty CurrentSince Apr 1, 2024 Accepting new patients
McLaren Central Michigan Single Specialty CurrentSince Oct 28, 2024 Accepting new patients
McLaren Central Michigan CurrentSince Oct 28, 2024 Accepting new patients
McLaren Central Michigan Single Specialty Current Accepting new patients
Portage Physician Practices Inc CurrentSince Apr 1, 2024 Accepting new patients
Portage Hospital LLC Past Accepting new patients
McLaren Central Michigan Past Accepting new patients

Locations

500 Campus Dr
Ste 5
Hancock, MI 49930
Phone (906) 483-1700

500 Campus Dr
Hancock, MI 49930
Phone (906) 483-1000

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

560 W Mitchell St
Ste 125
Petoskey, MI 49770
Phone (231) 487-3182

560 W Mitchell St
Ste 340
Petoskey, MI 49770
Phone (231) 348-9710

560 W Mitchell St
Ste 250
Petoskey, MI 49770
Phone (231) 487-3277

Organizations & group practices 7

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 2

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": "1704240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1093585820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CAMPUS DR",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CAMPUS DR",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301452",
            "telephone_number": "906-483-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINCHEK",
        "first_name": "HOLLY",
        "middle_name": "JANETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704278280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "WATKINS",
            "middle_name": "JANETTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hancock, MI

Sources for this page

Verify at the official NPI Registry.