Individual provider Active NPI

Holland Ravelle, M.D.

  • Diagnostic Radiology Physician
  • Eau Claire, WI
National Provider Identifier
1548290364
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
44999 Issued in WI
Practice address
1400 Bellinger St
Eau Claire, WI 54703-5222
Phone
(715) 838-5222
NPI assigned
Jul 4, 2006
Last updated
Mar 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology Physician 2085N0904X L5163 TX
Diagnostic Radiology Physician 2085R0202X 44999 WI Primary

Addresses

Primary practice location

1400 Bellinger St
Eau Claire, WI 54703-5222

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (715) 838-5222

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070613000379 WI Practitioner - Diagnostic Radiology 4183675895 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients
Medical X-Ray Consultants, LTD Nuclear Radiology CurrentSince Aug 8, 2025 Accepting new patients
Wisconsin Radiology Specialists, S C CurrentSince Jun 25, 2025 Accepting new patients
Premier Radiology Wisconsin, LLC Diagnostic Radiology CurrentSince Jun 25, 2025 Accepting new patients
Medical Xray Consultants, LTD PastSince May 16, 2021 Accepting new patients
Radiology Associates of San Antonio,P.a. Diagnostic Radiology Past Accepting new patients

Locations

900 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 717-4121

2321 Stout Rd
Menomonie, WI 54751
Phone (715) 235-5531

10180 Washington Ave
Mount Pleasant, WI 53177
Phone (414) 769-4040

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1548290364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BELLINGER ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547035222",
            "telephone_number": "715-838-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVELLE",
        "first_name": "HOLLAND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "TX",
            "license": "L5163",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "44999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

Verify at the official NPI Registry.