Individual provider Active NPI

Kristiann Holt, CPNP-PC

  • Pediatric Nurse Practitioner
  • Brownstown TWP, MI
National Provider Identifier
1568023778
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
4704289181 Issued in MI
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, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
4704289181MIMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Pediatric Associates P.C. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kholt602709@direct.hfhs.org
  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.