Individual provider Active NPI

Holland Thompson

  • Psychiatric/Mental Health Nurse Practitioner
  • Eagan, MN
National Provider Identifier
1225844228
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
12147 Issued in MN
Practice address
3450 Oleary LN
Eagan, MN 55123-2340
Phone
(651) 454-0114
NPI assigned
Dec 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 12147 MN Primary

Addresses

Primary practice location

3450 Oleary LN
Eagan, MN 55123-2340

Mailing address

3450 Oleary LN
Eagan, MN 55123-2340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250113000225 MN Practitioner - Nurse Practitioner 6800324302 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eagan Counseling ClinicGroup PAC ID 2860304045, 62 clinicians

Practice addresses (Care Compare)

3450 Oleary LN
Eagan, MN 55123-2340
Phone (651) 454-0114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12147MNMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Eagan Counseling Clinic CurrentSince Nov 10, 2024 Accepting new patients
Minnesota Teen Challenge, Inc CurrentSince Mar 1, 2025 Accepting new patients

Locations

2756 Douglas Dr N
Minneapolis, MN 55422
Phone (763) 544-9126

740 E 24th St
Minneapolis, MN 55404
Phone (612) 238-6238

9800 Rockford Rd
Ste 100
Plymouth, MN 55442
Phone (612) 559-0092

3450 Oleary Ln
Saint Paul, MN 55123
Phone (651) 454-0114

2365 Ariel St N
Saint Paul, MN 55109
Phone (612) 777-8987

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1225844228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 OLEARY LN",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551232340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 OLEARY LN",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551232340",
            "telephone_number": "651-454-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "HOLLAND",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "12147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.