NPIMap

Individual provider Active NPI

Kimberly Lynn Lanholm, MSN, APN, FNP-C

  • Family Nurse Practitioner
  • Pennsauken, NJ
National Provider Identifier
1235951849
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ15188000 Issued in NJ
Practice address
6981 North Park Drive, Suite 200a
Pennsauken, NJ 08109-4201
Phone
(856) 663-4949
Fax
(856) 663-6076
NPI assigned
Oct 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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 26NJ15188000 NJ Primary

Addresses

Primary practice location

6981 North Park Drive, Suite 200a
Pennsauken, NJ 08109-4201

Mailing address

301 Lippincott Drive, Suite 410
Marlton, NJ 08053
Phone (856) 355-0340

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address klanholm@virtua.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250128004337 NJ Practitioner - Nurse Practitioner 3779012224 Reassigns benefits to 1 organization

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
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

3242 Route 206
Bordentown, NJ 08505-4517

6981 N Park Dr
Pennsauken, NJ 08109-4201

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Feb 17, 2025 Accepting new patients
Virtua Medical Group, PA CurrentSince Feb 17, 2025 Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

141 Route 70 E
Ste E
Marlton, NJ 08053
Phone (856) 985-7373

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

303 Lippincott Dr
Ste 200
Marlton, NJ 08053
Phone (856) 355-0335

303 Lippincott Dr
Marlton, NJ 08053

6981 N Park Dr
Ste 200
Pennsauken, NJ 08109
Phone (856) 663-4949

6981 N Park Dr
Ste 200A
Pennsauken, NJ 08109
Phone (856) 663-4949

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1729900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1235951849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LIPPINCOTT DRIVE, SUITE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "08053",
            "telephone_number": "856-355-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6981 NORTH PARK DRIVE, SUITE 200A",
            "city": "PENNSAUKEN",
            "state": "NJ",
            "postal_code": "081094201",
            "telephone_number": "856-663-4949",
            "fax_number": "856-663-6076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANHOLM",
        "first_name": "KIMBERLY",
        "middle_name": "LYNN",
        "credential": "MSN, APN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-26",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ15188000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klanholm@virtua.org",
            "affiliation": "N",
            "address_1": "6981 North Park Drive, Suite 200A",
            "city": "Pennsauken",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "081094201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pennsauken, NJ

Sources for this page

Verify at the official NPI Registry.