Individual provider Active NPI

Heather Allison Holm, APRN, CNP

  • Family Nurse Practitioner
  • Spooner, WI
National Provider Identifier
1457189052
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
15616 Issued in WI
Practice address
1180 Chandler Dr
Spooner, WI 54801-2204
Phone
(715) 635-2151
NPI assigned
Jul 24, 2024
Last updated
Jul 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 15616 WI Primary

Addresses

Primary practice location

1180 Chandler Dr
Spooner, WI 54801-2204

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

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
I20240918002239 WI Practitioner - Nurse Practitioner 8325589377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Missouri, Columbia School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantage Physical Therapy and Sports Rehab, LLCGroup PAC ID 8022016336, shared by 3 NPIs, 289 clinicians
St Marys Hospital of SuperiorGroup PAC ID 8628964228, 96 clinicians

Practice addresses (Care Compare)

112 Ash St
Suite a
Spooner, WI 54801-1487
Phone (715) 635-3979

1180 Chandler Dr
Spooner, WI 54801-2204
Phone (715) 635-2151

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15616WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Hospital of Superior CurrentSince Sep 9, 2024 Accepting new patients
St. Mary's Duluth Clinic Health System Current Accepting new patients
St. Mary's Hospital of Superior CurrentSince Sep 9, 2024 Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

11134 N State Road 77
Hayward, WI 54843
Phone (715) 634-5505

1180 Chandler Dr
Spooner, WI 54801
Phone (715) 635-2151

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1457189052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 CHANDLER DR",
            "city": "SPOONER",
            "state": "WI",
            "postal_code": "548012204",
            "telephone_number": "715-635-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLM",
        "first_name": "HEATHER",
        "middle_name": "ALLISON",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "15616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spooner, WI

Sources for this page

Verify at the official NPI Registry.