Individual provider Active NPI

Holly E Murray, FNP

  • Family Nurse Practitioner
  • Coeur D Alene, ID
National Provider Identifier
1831677681
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
58406 Issued in ID
Practice address
913 W Canfield Ave
Coeur D Alene, ID 83815-9764
Phone
(208) 819-7103
Fax
(208) 719-0050
NPI assigned
Aug 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 58406 ID Primary

Addresses

Primary practice location

913 W Canfield Ave
Coeur D Alene, ID 83815-9764

Mailing address

913 W Canfield Ave
Coeur D Alene, ID 83815-9764
Phone (208) 819-7103

Other names 1

  • Holly Bergman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20181025001794 ID Practitioner - Nurse Practitioner 4183977846 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mind and Body RestoredGroup PAC ID 6901263417, 3 clinicians

Practice addresses (Care Compare)

913 W Canfield Ave
Coeur D Alene, ID 83815-9764
Phone (208) 957-7808

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kootenai Health, Inc. CurrentSince Aug 20, 2018 Accepting new patients
Kootenai Health, Inc. CurrentSince Aug 20, 2018 Accepting new patients
Incyte Pathology, PLLC Current Accepting new patients
Kootenai Health, Inc. Current Accepting new patients

Locations

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

1919 Lincoln Way
Ste 110
Coeur D Alene, ID 83814
Phone (208) 625-4515

1300 E Mullan Ave
Ste 700
Post Falls, ID 83854
Phone (208) 625-5564

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1533254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1831677681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 W CANFIELD AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838159764",
            "telephone_number": "208-819-7103",
            "fax_number": "208-719-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 W CANFIELD AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838159764",
            "telephone_number": "208-819-7103",
            "fax_number": "208-719-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "HOLLY",
        "middle_name": "E",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-03",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "58406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "BERGMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Coeur D Alene, ID

Sources for this page

Verify at the official NPI Registry.