Active NPI
Kimberly Erickson Holdener
- Pharmacist
- Madison, WI
National Provider Identifier
1508936105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14008-040
- Practice address
- 600 Highland Ave
Pharmacy Dept. Mailcode 1530
Madison, WI 53792-0001 - Phone
- (608) 263-1290
- NPI assigned
- Nov 9, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 14008-040 | WI | Primary |
| Pharmacist | 183500000X | 117641-2 | MN | |
| Pharmacist | 183500000X | 26020453A | IN |
Addresses
Primary practice location
600 Highland Ave
Pharmacy Dept. Mailcode 1530
Madison, WI 53792-0001
Mailing address
5240 Snapdragon TRL
Fitchburg, WI 53711-7642
Phone (608) 263-1290
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 117641-2 | Other | MN | PHARMACIST |
| 14008-040 | Other | WI | PHARMACIST |
| 26020453A | Other | IN | PHARMACIST |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 26020453A | IN | MD | Pharmacist |
| 117641-2 | MN | MD | Pharmacist |
| 14008-040 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508936105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5240 SNAPDRAGON TRL",
"city": "FITCHBURG",
"state": "WI",
"postal_code": "537117642",
"telephone_number": "608-263-1290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 HIGHLAND AVE",
"address_2": "PHARMACY DEPT. MAILCODE 1530",
"city": "MADISON",
"state": "WI",
"postal_code": "537920001",
"telephone_number": "608-263-1290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLDENER",
"first_name": "KIMBERLY",
"middle_name": "ERICKSON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "14008-040",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "117641-2",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26020453A",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST",
"identifier": "117641-2",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST",
"identifier": "14008-040",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST",
"identifier": "26020453A",
"state": "IN"
}
],
"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 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.