Individual provider Active NPI

Casey M Hierholzer

  • Licensed Practical Nurse
  • Watertown, NY
National Provider Identifier
1316825680
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
334944 Issued in NY
Practice address
611 W Main St
Watertown, NY 13601-1337
Phone
(315) 788-1530
NPI assigned
Aug 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 334944 NY Primary

Addresses

Primary practice location

611 W Main St
Watertown, NY 13601-1337

Mailing address

611 W Main St
Watertown, NY 13601-1337
Phone (315) 788-1530

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
334944NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Wellness and Recovery, Inc CurrentSince Sep 3, 2025 Accepting new patients

Locations

611 W Main St
Watertown, NY 13601
Phone (315) 788-1530

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": "1756080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1316825680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W MAIN ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011337",
            "telephone_number": "315-788-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W MAIN ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011337",
            "telephone_number": "315-788-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIERHOLZER",
        "first_name": "CASEY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-25",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "334944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; 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.