Active NPI
Kristopher Holaday, M.D.
- Hospitalist Physician
- Fargo, ND
National Provider Identifier
1780035543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 15874
- Practice address
- 5225 23Rd Ave S
Fargo, ND 58104-7927 - Phone
- (701) 417-2575
- NPI assigned
- Jun 23, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Hospitalist Physician | 208M00000X | 15874 | ND | Primary |
Addresses
Primary practice location
5225 23Rd Ave S
Fargo, ND 58104-7927
Mailing address
2800 Chicago Ave
#250
Minneapolis, MN 55407-1318
Phone (612) 863-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- University of North Dakota School of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5225 23Rd Ave S
Fargo, ND 58104-7927
Phone (701) 417-2575
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.73 of 100
- Quality
- 71.75
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.68
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27918 | MN | MD | Pediatric Otolaryngology Physician |
| 15874 | ND | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Medical Center Fargo | Current | Accepting new patients | |
| Sanford Medical Center Fargo | Current | Accepting new patients |
Locations
5225 23rd Ave S
Fargo, ND 58104
Phone (701) 234-5933
2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800
1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445
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 and National Provider Directory roles.
-
- Family Medicine Physician
- West Fargo, ND
- NPI 1184917924
-
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fargo, ND
- NPI 1245519081
-
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
-
- Critical Access Hospital
- Perham, MN
- NPI 1790799518
-
- Ambulatory Surgical Clinic/Center
- Bemidji, MN
- NPI 1093876922
Hospital
-
- Rural Acute Care Hospital
- Detroit Lakes, MN
- NPI 1679561088
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568937600000",
"number": "1780035543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 CHICAGO AVE",
"address_2": "#250",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554071318",
"telephone_number": "612-863-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5225 23RD AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "581047927",
"telephone_number": "701-417-2575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLADAY",
"first_name": "KRISTOPHER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-06-23",
"last_updated": "2019-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "ND",
"license": "15874",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.