Individual provider Active NPI

John Edward Holte, O.D.

  • Optometrist
  • Cannon Falls, MN
National Provider Identifier
1659455384
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1659 Issued in MN
Practice address
6487 Cedar Hills Dr
Cannon Falls, MN 55009-4264
Phone
(507) 263-3949
Fax
(507) 263-2295
NPI assigned
Oct 25, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1659 MN Primary

Addresses

Primary practice location

6487 Cedar Hills Dr
Cannon Falls, MN 55009-4264

Mailing address

PO Box 218
Cannon Falls, MN 55009-0218
Phone (507) 263-3949

Other identifiers 1

IdentifierTypeStateIssuer
0468490001OtherMNADMINASTAR

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1659MNMDOptometrist

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659455384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 218",
            "city": "CANNON FALLS",
            "state": "MN",
            "postal_code": "550090218",
            "telephone_number": "507-263-3949",
            "fax_number": "507-263-2295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6487 CEDAR HILLS DR",
            "city": "CANNON FALLS",
            "state": "MN",
            "postal_code": "550094264",
            "telephone_number": "507-263-3949",
            "fax_number": "507-263-2295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTE",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "1659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINASTAR",
            "identifier": "0468490001",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cannon Falls, MN

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.

Verify at the official NPI Registry.