Mary K Holm, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

6960 Issued in ND

Practice address

3000 32ND Ave S
Fargo, ND 58103-6132

Phone

(701) 364-8000

Fax

(701) 364-8078

NPI assigned

Jul 3, 2006

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

Other identifiers 14

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Sanford School of Medicine of University of South Dakota, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakewood Health SystemGroup PAC ID 1052229671, shared by 15 NPIs, 107 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lakewood Health System Hospital, Staples, MN, CCN 241329

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mholm623309@direct.ochin.org
• Direct secure messaging: mholm571529@ehrdirect.mayoclinicmsg.org

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.

• County of Meeker

  • Rural Health Clinic/Center
  • Litchfield, MN
  • NPI 1083221816
  Medicare reassignment NPD
• Lakewood Health System

  • Critical Access Hospital
  • Staples, MN
  • NPI 1295726362
  Medicare reassignment NPD
• Lakewood Health System

  • Rural Health Clinic/Center
  • Staples, MN
  • NPI 1841280823
  Medicare reassignment NPD
• Mayo Clinic Health System-Southeast Minnesota Region

  • Multi-Specialty Clinic/Center
  • Albert Lea, MN
  • NPI 1891701637
  Medicare reassignment NPD
• Perham Hospital District

  • Critical Access Hospital
  • Perham, MN
  • NPI 1790799518
  Medicare reassignment NPD
• Riverview Healthcare Association

  • Multi-Specialty Clinic/Center
  • East Grand Forks, MN
  • NPI 1811918436
  Medicare reassignment NPD
• Riverview Healthcare Association

  • Rural Health Clinic/Center
  • Crookston, MN
  • NPI 1487944898
  Medicare reassignment
• County of Meeker

  • Medicare Defined Swing Bed Hospital Unit
  • Litchfield, MN
  • NPI 1578718482
  NPD
• Lakewood Health System

  • Community/Retail Pharmacy
  • Pillager, MN
  • NPI 1396519906
  NPD
• Mayo Clinic Health System-Southeast Minnesota Region

  • Clinic Pharmacy
  • Cannon Falls, MN
  • NPI 1699597468
  NPD
• Riverview Healthcare Association

  • Critical Access Hospital
  • Crookston, MN
  • NPI 1477525566
  NPD
• Riverview Healthcare Association

  • Physical Therapy Clinic/Center
  • Fertile, MN
  • NPI 1659045987
  NPD

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

• Lakewood Health System

  • Critical Access Hospital
  • Staples, MN
  • NPI 1295726362
  Care Compare affiliation

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1477583664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6001",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581086001",
            "telephone_number": "701-364-3300",
            "fax_number": "701-364-8906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 32ND AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036132",
            "telephone_number": "701-364-8000",
            "fax_number": "701-364-8078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Hewitt Blvd",
            "address_purpose": "LOCATION",
            "city": "Red Wing",
            "state": "MN",
            "postal_code": "550662848",
            "country_code": "US",
            "telephone_number": "651-267-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLM",
        "first_name": "MARY",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ND",
            "license": "6960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA #",
            "identifier": "0701529",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "587814400",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS #",
            "identifier": "HP19491",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA #",
            "identifier": "0702336",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MNBS #",
            "identifier": "6T548HO",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NDBS #",
            "identifier": "12465",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE #",
            "identifier": "142015",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE #",
            "identifier": "DDA9011015539",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA #",
            "identifier": "0701528",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MNBS #",
            "identifier": "67D25HO",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LHS #",
            "identifier": "ND200022",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NDBS #",
            "identifier": "17944",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18142",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIOUX VALLEY #",
            "identifier": "13809",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mholm571529@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "701 Hewitt Blvd",
            "city": "Red Wing",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550662848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amanda Holland, RN
• Craig W Holland, DO
• Lauren Rose Hollingsworth, MD
• Andrea Holloway, OTR/L
• Kayla Rose Holloway
• Amy Holman, CRNA
• Brent L Holman, DDS
• Jodi Jean Holman, RN
• Pauline Holman, MS, CGC
• Shirley Holmen

• Obstetrics & Gynecology Physician in Fargo, ND
• Providers in Fargo, ND by specialty
• Obstetrics & Gynecology Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.