Active NPI
Carol Ann Holm, RN
- Registered Nurse
- Portland, OR
National Provider Identifier
1407116569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 083037318RN
- Practice address
- 3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964 - Phone
- (503) 220-8262
- NPI assigned
- May 23, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 083037318RN | OR | Primary |
Addresses
Primary practice location
3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964
Mailing address
20720 SW Mountain Home Rd
Sherwood, OR 97140-8635
Phone (503) 628-3766
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 083037318RN | OR | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337731200000",
"number": "1407116569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20720 SW MOUNTAIN HOME RD",
"city": "SHERWOOD",
"state": "OR",
"postal_code": "971408635",
"telephone_number": "503-628-3766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3710 SW US VETERANS HOSPITAL RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972392964",
"telephone_number": "503-220-8262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLM",
"first_name": "CAROL",
"middle_name": "ANN",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-23",
"last_updated": "2012-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OR",
"license": "083037318RN",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.