Individual provider Active NPI

Holly J Reich, APNP

  • Nurse Practitioner
  • Waukesha, WI
National Provider Identifier
1306922919
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1959 033 Issued in WI
Practice address
2717 N Grandview Blvd
#202
Waukesha, WI 53188
Phone
(262) 513-0700
Fax
(262) 513-0707
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1959 033 WI Primary

Addresses

Primary practice location

2717 N Grandview Blvd
#202
Waukesha, WI 53188

Mailing address

2717 N Grandview Blvd
#202
Waukesha, WI 53188
Phone (262) 513-0700

Other identifiers 1

IdentifierTypeStateIssuer
43967200MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20040525001454 WI Practitioner - Nurse Practitioner 6002897196 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cary J Kohlenberg MD SCGroup PAC ID 9537140611, 9 clinicians

Practice addresses (Care Compare)

10507 S Chicago Rd
Oak Creek, WI 53154-6605
Phone (414) 764-3303

8208 Racine Ave
Wind Lake, WI 53185-1440
Phone (414) 617-9190

845 County NN
Mukwonago, WI 53149
Phone (262) 363-6830

Merit-based Incentive Payment System (MIPS)

Final score
35.83 of 100Reported as group
Quality
9.6
Promoting interoperability
0
Improvement activities
0
Cost
76.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1959 033WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cary J Kohlenberg MD SC CurrentSince Jul 1, 2002 Accepting new patients

Locations

6735 W Bradley Rd
Milwaukee, WI 53223
Phone (414) 354-3300

845 Highway NN E
Mukwonago, WI 53149
Phone (262) 363-6830

2717 N Grandview Blvd
Ste 102
Waukesha, WI 53188
Phone (262) 513-0700

2717 N Grandview Blvd
Ste 202
Waukesha, WI 53188
Phone (262) 513-0700

9047 W Greenfield Ave
West Allis, WI 53214
Phone (414) 453-9290

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306922919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 N GRANDVIEW BLVD",
            "address_2": "#202",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "53188",
            "telephone_number": "262-513-0700",
            "fax_number": "262-513-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 N GRANDVIEW BLVD",
            "address_2": "#202",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "53188",
            "telephone_number": "262-513-0700",
            "fax_number": "262-513-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REICH",
        "first_name": "HOLLY",
        "middle_name": "J",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "1959 033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43967200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.