Individual provider Active NPI

Sally K Holstege, FNP

  • Family Nurse Practitioner
  • Wyoming, MI
National Provider Identifier
1770471716
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704356349 Issued in MI
Practice address
781 36TH St SE
Wyoming, MI 49548-2319
Phone
(616) 252-4100
NPI assigned
Jun 26, 2025
Last updated
Jun 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704356349 MI Primary
Registered Nurse 163W00000X 4704356349 MI

Addresses

Primary practice location

781 36TH St SE
Wyoming, MI 49548-2319

Mailing address

781 36TH St SE
Wyoming, MI 49548-2319
Phone (616) 252-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251007004139 MI Practitioner - Nurse Practitioner 6204333107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5900 Byron Ctr Ave SW
Wyoming, MI 49519-9606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Hospital CurrentSince Oct 1, 2025 Accepting new patients
Metropolitan Hospital CurrentSince Oct 1, 2025 Accepting new patients

Locations

781 36th St SE
Wyoming, MI 49548
Phone (616) 252-4100

Organizations & group practices 2

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": "1750896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1770471716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "781 36TH ST SE",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495482319",
            "telephone_number": "616-252-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 36TH ST SE",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495482319",
            "telephone_number": "616-252-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLSTEGE",
        "first_name": "SALLY",
        "middle_name": "K",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-26",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704356349",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704356349",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.