NPIMap

Individual provider Active NPI

Chelsea Loran Holtz, D.O

  • Family Medicine Physician
  • Shorewood, WI
National Provider Identifier
1306280276
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
63269 Issued in WI
Practice address
4027 N Oakland Ave
Shorewood, WI 53211-2356
Phone
(414) 962-7477
NPI assigned
Apr 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 63269 WI Primary

Addresses

Primary practice location

4027 N Oakland Ave
Shorewood, WI 53211-2356

Mailing address

4027 N Oakland Ave
Shorewood, WI 53211-2356
Phone (414) 962-7477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20160816000604 WI Practitioner - Family Practice 9739408113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

801 S 70TH St
West Allis, WI 53214-3147
Phone (414) 773-6600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
63269WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary's Hospital Milwaukee, Inc CurrentSince Sep 12, 2016 Accepting new patients
Columbia St. Mary's Hospital Milwaukee, Inc Family Medicine Current Accepting new patients
Columbia St. Mary's Hospital Milwaukee Inc CurrentSince Sep 12, 2016 Accepting new patients
Columbia St. Mary's Hospital Milwaukee, Inc Family Medicine Past Accepting new patients

Locations

4425 N Port Washington Rd
Glendale, WI 53212
Phone (414) 326-2218

1901 E Capitol Dr
Shorewood, WI 53211
Phone (414) 424-5300

4027 N Oakland Ave
Shorewood, WI 53211
Phone (414) 319-3080

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Organizations & group practices 4

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 5

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": "1366675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1306280276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4027 N OAKLAND AVE",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532112356",
            "telephone_number": "414-962-7477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4027 N OAKLAND AVE",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532112356",
            "telephone_number": "414-962-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTZ",
        "first_name": "CHELSEA",
        "middle_name": "LORAN",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-23",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "63269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shorewood, WI

Sources for this page

Verify at the official NPI Registry.