Active NPI
Melanie Louise Holt
- Registered Nurse
- Sun Prairie, WI
National Provider Identifier
1578739025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 176837-30
- Practice address
- 3004 Edmonton Dr
Sun Prairie, WI 53590-4278 - Phone
- (262) 424-8727
- NPI assigned
- May 5, 2008
- Last updated
- May 21, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 176837-30 | WI | Primary |
Addresses
Primary practice location
3004 Edmonton Dr
Sun Prairie, WI 53590-4278
Mailing address
3004 Edmonton Dr
Sun Prairie, WI 53590-4278
Phone (262) 424-8727
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35057500 | Medicaid | WI |
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 |
|---|---|---|---|
| 176837-30 | WI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337558400000",
"number": "1578739025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3004 EDMONTON DR",
"city": "SUN PRAIRIE",
"state": "WI",
"postal_code": "535904278",
"telephone_number": "262-424-8727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3004 EDMONTON DR",
"city": "SUN PRAIRIE",
"state": "WI",
"postal_code": "535904278",
"telephone_number": "262-424-8727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLT",
"first_name": "MELANIE",
"middle_name": "LOUISE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-05",
"last_updated": "2012-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "176837-30",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "35057500",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sun Prairie, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.