NPIMap

Individual provider Active NPI

Nicholas Hollenbeck, CNP

  • Family Nurse Practitioner
  • Rapid City, SD
National Provider Identifier
1154981694
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP001583 Issued in SD
Practice address
4150 5TH St
Rapid City, SD 57701-6022
Phone
(605) 755-4300
NPI assigned
Jun 17, 2019
Last updated
Jun 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CP001583 SD Primary

Addresses

Primary practice location

4150 5TH St
Rapid City, SD 57701-6022

Mailing address

6853 E Daisy Dr
Black Hawk, SD 57718-9842
Phone (605) 951-1862

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, WY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190819001256 SD Practitioner - Nurse Practitioner 3173851920 Reassigns benefits to 1 organization
I20240923002790 WY Practitioner - Nurse Practitioner 3173851920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-8109

620 Four-J CT
Unit a
Gillette, WY 82716-4130
Phone (605) 755-0682

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital Inc CurrentSince Jul 10, 2019 Accepting new patients
Monument Health Rapid City Hospital, Inc CurrentSince Aug 1, 2024 Accepting new patients
Monument Health Rapid City Hospital, Inc. CurrentSince Jul 10, 2019 Accepting new patients
Monument Health Rapid City Hospital, Inc. Past Accepting new patients

Locations

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

4150 5th St
Rapid City, SD 57701
Phone (605) 399-4300

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.

Hospital & facility affiliations 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1154981694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6853 E DAISY DR",
            "city": "BLACK HAWK",
            "state": "SD",
            "postal_code": "577189842",
            "telephone_number": "605-951-1862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 5TH ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016022",
            "telephone_number": "605-755-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLENBECK",
        "first_name": "NICHOLAS",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-17",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP001583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.