Active NPI
Kristiann Holt, CPNP-PC
- Pediatric Nurse Practitioner
- Brownstown TWP, MI
National Provider Identifier
1568023778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 4704289181
- Practice address
- 23050 West Rd Ste 110
Brownstown TWP, MI 48183-1470 - Phone
- (734) 671-9800
- NPI assigned
- Jun 27, 2019
- Last updated
- Jun 27, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 4704289181 | MI | Primary |
Addresses
Primary practice location
23050 West Rd Ste 110
Brownstown TWP, MI 48183-1470
Mailing address
32137 Groat Blvd
Rockwood, MI 48173-8635
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 |
|---|---|---|---|
| 4704289181 | MI | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Downriver Pediatric Associates P.C. | Past | Accepting new patients |
Interoperability endpoints
- kholt602709@direct.hfhs.org
- kholts505967@direct.hfhs.org
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Brownstown TWP, MI
- NPI 1124137534
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561593600000",
"number": "1568023778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32137 GROAT BLVD",
"city": "ROCKWOOD",
"state": "MI",
"postal_code": "481738635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23050 WEST RD STE 110",
"city": "BROWNSTOWN TWP",
"state": "MI",
"postal_code": "481831470",
"telephone_number": "734-671-9800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLT",
"first_name": "KRISTIANN",
"credential": "CPNP-PC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-27",
"last_updated": "2019-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MI",
"license": "4704289181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brownstown TWP, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.