Active NPI
Kristin A Holm, MD
- Pulmonary Disease Physician
- Waterville, ME
National Provider Identifier
1174599450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 014498
- Practice address
- 149 North St
Waterville, ME 04901-4974 - Phone
- (207) 872-1715
- Fax
- (207) 872-1725
- NPI assigned
- Feb 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 014498 | ME | Primary |
Addresses
Primary practice location
149 North St
Waterville, ME 04901-4974
Mailing address
149 North St
Waterville, ME 04901-4974
Phone (207) 872-1715
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 268730099 | Medicaid | ME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014498 | ME | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainegeneral Medical Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Augusta, ME
- NPI 1083949184
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353974400000",
"number": "1174599450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "149 NORTH ST",
"city": "WATERVILLE",
"state": "ME",
"postal_code": "049014974",
"telephone_number": "207-872-1715",
"fax_number": "207-872-1725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "149 NORTH ST",
"city": "WATERVILLE",
"state": "ME",
"postal_code": "049014974",
"telephone_number": "207-872-1715",
"fax_number": "207-872-1725"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLM",
"first_name": "KRISTIN",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-27",
"last_updated": "2012-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "ME",
"license": "014498",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "268730099",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Waterville, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.