Active NPI
John Daniel Holstine, MD
- Urology Physician
- Fairmont, MN
National Provider Identifier
1205833746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 19394
- Practice address
- 800 Medical Center Dr
Fairmont, MN 56031-4575 - Phone
- (507) 235-6036
- Fax
- (507) 235-8882
- NPI assigned
- Jun 30, 2005
- Last updated
- Apr 12, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 19394 | MN | Primary |
| Urology Physician | 208800000X | 17358 | IA |
Addresses
Primary practice location
800 Medical Center Dr
Fairmont, MN 56031-4575
Mailing address
800 Medical Center Dr
Fairmont, MN 56031-4575
Phone (507) 235-6036
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0951178 | Other | IOWA MEDICAL ASSIST. | |
| 341095099 | Other | RAILROAD MEDICARE | |
| 691768200 | Medicaid | MN |
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 |
|---|---|---|---|
| 17358 | IA | MD | Urology Physician |
| 19394 | MN | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334188800000",
"number": "1205833746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 MEDICAL CENTER DR",
"city": "FAIRMONT",
"state": "MN",
"postal_code": "560314575",
"telephone_number": "507-235-6036",
"fax_number": "507-235-8882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 MEDICAL CENTER DR",
"city": "FAIRMONT",
"state": "MN",
"postal_code": "560314575",
"telephone_number": "507-235-6036",
"fax_number": "507-235-8882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLSTINE",
"first_name": "JOHN",
"middle_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-30",
"last_updated": "2012-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "MN",
"license": "19394",
"primary": true
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "IA",
"license": "17358",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IOWA MEDICAL ASSIST.",
"identifier": "0951178",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "341095099",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "691768200",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairmont, MN
- Lexie Danielle Harmening, PHARM.D.
- Harvest Health LLC
- Hearing Health Centers, P.C. (Fairmont Hearing Aid Service)
- Kelly Jean Hollingsworth, LPCC
- Javen Delano Holm, OD
- Charles Hounshell, DPM
- Human Services of Faribault & Martin Counties
- Hy-Vee Inc (Hy-Vee Pharmacy (1183))
- Independent School District #2752
- Integrity Medical Center, P.a. (Integrity Medical Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.