Alicia Barkholtz

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F06222127 Issued in WI

Practice address

180 Knights Way
Fond Du Lac, WI 54935-8027

Phone

(920) 922-5433

NPI assigned

Aug 25, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 9, 2024 through Jul 9, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Fox Valley Wellness Center/Midwest Hyperbarics

  • Specialist
  • Fond Du Lac, WI
  • NPI 1821376419
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1407575004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W7157 HILLVIEW RD",
            "city": "GREENVILLE",
            "state": "WI",
            "postal_code": "549429502",
            "telephone_number": "920-205-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 KNIGHTS WAY",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549358027",
            "telephone_number": "920-922-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARKHOLTZ",
        "first_name": "ALICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-25",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "F06222127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Baehr Chiropractic Center SC
• Bago Shore Enterprises LLC
• Sherry Baillies
• Bobbie Baker
• Janelle B Baldwin, NBC-HWC
• Bryce Bartelt, BCBA
• Karen Joan Bartelt, OTR
• Kodi Denise Barthels, SAC-IT
• Richard L Bartz
• Theresa J Baseley, NP

• Family Nurse Practitioner in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.