Individual provider Active NPI

Brian B Holmquist, MOT OTR

  • Occupational Therapist
  • Madison, WI
National Provider Identifier
1336190222
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
3761026 Issued in WI
Practice address
6515 Watts Rd
Suit 206
Madison, WI 53719-2726
Phone
(608) 238-5826
Fax
(608) 238-1221
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3761026 WI Primary

Addresses

Primary practice location

6515 Watts Rd
Suit 206
Madison, WI 53719-2726

Mailing address

6515 Watts Rd
Suite 206
Madison, WI 53719-2726
Phone (608) 238-5826

Other identifiers 1

IdentifierTypeStateIssuer
40870200MedicaidWI

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
3761026WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Regent Mental Health Group SC PastSince Nov 1, 2002 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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215734400000",
    "number": "1336190222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6515 WATTS RD",
            "address_2": "SUITE 206",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537192726",
            "telephone_number": "608-238-5826",
            "fax_number": "608-238-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6515 WATTS RD",
            "address_2": "SUIT 206",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537192726",
            "telephone_number": "608-238-5826",
            "fax_number": "608-238-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMQUIST",
        "first_name": "BRIAN",
        "middle_name": "B",
        "credential": "MOT OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2008-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "3761026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40870200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; 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.