NPIMap

Individual provider Active NPI

Chantel J Holz

  • Nurse Practitioner
  • Rapid City, SD
National Provider Identifier
1295042075
Registry record updated Dec 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CP000615 Issued in SD
Practice address
2820 Mount Rushmore Rd
Rapid City, SD 57701-5462
Phone
(605) 342-3280
NPI assigned
Sep 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CP000615 SD Primary

Addresses

Primary practice location

2820 Mount Rushmore Rd
Rapid City, SD 57701-5462

Mailing address

PO Box 6020
Rapid City, SD 57709-6020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20101206000404 SD Practitioner - Nurse Practitioner 1951598820 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CP000615SDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Black Hills Surgical Hospital, LLC CurrentSince Sep 5, 2023 Accepting new patients
Black Hills Surgical Hospital, LLC CurrentSince Sep 5, 2023 Accepting new patients
Rapid City Regional Hospital Inc CurrentSince May 13, 2015 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince May 13, 2015 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Black Hills Dermatology PC Past Accepting new patients

Locations

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

216 Anamaria Dr
Rapid City, SD 57701
Phone (605) 388-9440

1868 Lombardy Dr
Rapid City, SD 57703
Phone (605) 721-4900

Interoperability endpoints

  • Direct secure messaging: cholz.13499@regionalhealth.sdhealthlink.net

Organizations & group practices 6

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 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513209600000",
    "number": "1295042075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6020",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577096020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 MOUNT RUSHMORE RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577015462",
            "telephone_number": "605-342-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLZ",
        "first_name": "CHANTEL",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-01",
        "last_updated": "2017-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SD",
            "license": "CP000615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.