Individual provider Active NPI

Mary Linda Holmstrom, REGISTERED NURSE

  • Registered Nurse
  • Anchorage, AK
National Provider Identifier
1306152194
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
27629 Issued in AK
Practice address
3841 Piper St
Ste T4-054
Anchorage, AK 99508
Phone
(907) 562-6228
Fax
(907) 562-6868
NPI assigned
Aug 31, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 27629 AK Primary

Addresses

Primary practice location

3841 Piper St
Ste T4-054
Anchorage, AK 99508

Mailing address

3841 Piper St.
Ste T4-054
Anchorage, AK 99508
Phone (907) 562-6228

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
27629AKMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy Asthma and Immunology Center of Alaska LLC PastSince Oct 3, 2015 Accepting new patients

Organizations & group practices 1

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": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1306152194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 PIPER ST.",
            "address_2": "STE T4-054",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99508",
            "telephone_number": "907-562-6228",
            "fax_number": "907-562-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3841 PIPER ST",
            "address_2": "STE T4-054",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99508",
            "telephone_number": "907-562-6228",
            "fax_number": "907-562-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMSTROM",
        "first_name": "MARY",
        "middle_name": "LINDA",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-31",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AK",
            "license": "27629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.