Laura Elizabeth Holzum, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2019042541 Issued in MO

Practice address

3878 Pershall Rd
Ferguson, MO 63135-1246

Phone

(314) 839-7500

NPI assigned

Jun 29, 2011

Last updated

May 6, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lholzum353262@direct-ehr-ssmhc.com

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.

• SSM Health Care St Louis

  dba SSM Health St Clare Fenton

  • Emergency Medicine Physician
  • Fenton, MO
  • NPI 1275586174
  Medicare reassignment NPD
• SSM Cardinal Glennon Childrens Hospital

  dba SSM Health Cardinal Glennon Children's Hospital

  • Pediatrics Physician
  • O'Fallon, IL
  • NPI 1174577670

  MO

  Medicare reassignment NPD
• SSM Cardinal Glennon Children's Hospital

  dba SSM Health Cardinal Glennon Pediatrics

  • Pediatrics Physician
  • Warrenton, MO
  • NPI 1962573212
  NPD
• SSM Health Care St. Louis

  dba SSM Health DePaul Hospital

  • Cardiovascular Disease Physician
  • Bridgeton, MO
  • NPI 1376598599
  NPD
• Lasalle Medical Associates

  • Multi-Specialty Clinic/Center
  • Fontana, CA
  • NPI 1275661084
  NPD (past)
• Lasalle Medical Associates

  • Multi-Specialty Clinic/Center
  • Rialto, CA
  • NPI 1881150290
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1770870776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3878 PERSHALL RD",
            "city": "FERGUSON",
            "state": "MO",
            "postal_code": "631351246",
            "telephone_number": "314-839-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3878 PERSHALL RD",
            "city": "FERGUSON",
            "state": "MO",
            "postal_code": "631351246",
            "telephone_number": "314-839-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17577 Arrow Blvd",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "923354011",
            "country_code": "US",
            "telephone_number": "909-890-0407",
            "fax_number": "909-890-0575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLZUM",
        "first_name": "LAURA",
        "middle_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-29",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-134840",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2019042541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036134840",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melonee Harris
• Hartnett Christian Village
• Healing Hearts Home Care LLC
• Heavens Coverage LLC
• Dobbie Herrion, ED.D
• Integrity Plus Home Care LLC
• Integrity Plus in-Home Care LLC
• Alyssa Simone Jackson
• Jamaa Birth Village
• Brya Kimnita Johnson, MSW

• Pediatrics Physician in Ferguson, MO
• Providers in Ferguson, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.