NPIMap

Individual provider Active NPI

Todd H Holm, M.D.

  • Family Medicine Physician
  • Prior Lake, MN
National Provider Identifier
1811971179
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37742 Issued in MN
Practice address
16276 Lakeside Ave SE
Prior Lake, MN 55372-2493
Phone
(952) 237-2627
NPI assigned
Dec 1, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 37742 MN Primary
Family Medicine Physician 207Q00000X 33633-20 WI

Addresses

Primary practice location

16276 Lakeside Ave SE
Prior Lake, MN 55372-2493

Mailing address

270 Main St N Ste 300
Stillwater, MN 55082-6788
Phone (651) 342-1039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100202000760 MN Practitioner - Family Practice 7517000342
I20240123001901 WI Practitioner - Family Practice 7517000342

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Mayo Medical School, 1991
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

270 Main St N
Suite 300
Stillwater, MN 55082-6788

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1811971179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 MAIN ST N STE 300",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826788",
            "telephone_number": "651-342-1039",
            "fax_number": "651-342-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16276 LAKESIDE AVE SE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553722493",
            "telephone_number": "952-237-2627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLM",
        "first_name": "TODD",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "37742",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "33633-20",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prior Lake, MN

Sources for this page

Verify at the official NPI Registry.