Active NPI
Holly Kristine Levine, MD
- Family Medicine Physician
- Saint Cloud, MN
National Provider Identifier
1215917216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 46257
- Practice address
- 720 4TH Ave S
Student Health Service
Saint Cloud, MN 56301-4442 - Phone
- (320) 308-4856
- Fax
- (320) 308-3192
- NPI assigned
- Jan 18, 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 46257 | MN | Primary |
Addresses
Primary practice location
720 4TH Ave S
Student Health Service
Saint Cloud, MN 56301-4442
Mailing address
720 4TH Ave S
Student Health Service
Saint Cloud, MN 56301-4442
Phone (320) 308-4856
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 |
|---|---|---|---|
| 46257 | MN | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191542400000",
"number": "1215917216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 4TH AVE S",
"address_2": "STUDENT HEALTH SERVICE",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563014442",
"telephone_number": "320-308-4856",
"fax_number": "320-308-3192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 4TH AVE S",
"address_2": "STUDENT HEALTH SERVICE",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563014442",
"telephone_number": "320-308-4856",
"fax_number": "320-308-3192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVINE",
"first_name": "HOLLY",
"middle_name": "KRISTINE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-18",
"last_updated": "2007-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "46257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.