Javen D. Holm OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

MN2192 Issued in MN

Legal business name

JAVEN D. HOLM OD PA

Doing business as

Family Eye Care

Practice address

1210 East Blue Earth Avenue
Fairmont, MN 56031-4441

Phone

(507) 238-3363

NPI assigned

Dec 6, 2006

Last updated

Dec 14, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Javen Delano Holm, ODNPI 1285630632

Title

Owner

Phone

(507) 238-3363

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Family Eye Care Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Javen Delano Holm, OD

  • Optometrist
  • Fairmont, MN
  • NPI 1285630632
  Authorized official Same address or phone
• Brian Darrell Smith, O.D.

  • Optometrist
  • Milltown, WI
  • NPI 1366483612
  NPD (past)
• April Dawn Svoboda Smith, OD

  • Optometrist
  • Siren, WI
  • NPI 1861464307
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1093874364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 EAST BLUE EARTH AVENUE",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314441",
            "telephone_number": "507-238-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 EAST BLUE EARTH AVENUE",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314441",
            "telephone_number": "507-238-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAVEN D. HOLM OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2010-12-14",
        "status": "A",
        "authorized_official_last_name": "HOLM",
        "authorized_official_first_name": "JAVEN",
        "authorized_official_middle_name": "DELANO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "507-238-3363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "MN2192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEC GLASSES NUMBER",
            "identifier": "972N0FA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "C03824",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039223500",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051651100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JAVEN HOLM OD NPI",
            "identifier": "1285630632",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR HOLM BCBS #",
            "identifier": "972N8FA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Fairmont, MN
• Providers in Fairmont, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.