Active NPI
Nicole Holzem
- Skilled Nursing Facility
- Wausau, WI
National Provider Identifier
1679749667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 1419-019
- Practice address
- 3107 Westhill Dr
Wausau, WI 54401-3774 - Phone
- (715) 845-8444
- NPI assigned
- Apr 30, 2008
- 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 |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1419-019 | WI | Primary |
Addresses
Primary practice location
3107 Westhill Dr
Wausau, WI 54401-3774
Mailing address
704 W Crocker St
Wausau, WI 54401-2130
Phone (715) 842-0575
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 |
|---|---|---|---|
| 1419-019 | WI | MD | Skilled Nursing Facility |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| NSH Wausau LLC | Skilled Nursing Facility | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Skilled Nursing Facility
- Wausau, WI
- NPI 1194243998
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761264000000",
"number": "1679749667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "704 W CROCKER ST",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544012130",
"telephone_number": "715-842-0575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3107 WESTHILL DR",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544013774",
"telephone_number": "715-845-8444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLZEM",
"first_name": "NICOLE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-30",
"last_updated": "2025-10-24",
"certification_date": "2025-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "WI",
"license": "1419-019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wausau, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.