Individual provider Active NPI

Laray Sue Holiman, CNM, WHNP-BC

  • Advanced Practice Midwife
  • Belcourt, ND
National Provider Identifier
1831976059
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
CNM08603 Issued in MD
Practice address
1300 Hospital Loop
Belcourt, ND 58316-7712
Phone
(701) 477-8477
NPI assigned
Sep 11, 2023
Last updated
Sep 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 104061530 IL
Advanced Practice Midwife 367A00000X CNM08603 MD Primary

Addresses

Primary practice location

1300 Hospital Loop
Belcourt, ND 58316-7712

Mailing address

201 John St
Rolette, ND 58366-7015
Phone (501) 802-4641

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250314002030 TX Practitioner - Certified Nurse Midwife (CNM) 5496277824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quentin N Burdick Comprehensive Health Care FacilityGroup PAC ID 5496651853, 38 clinicians

Practice addresses (Care Compare)

PO Box
160 1300 Hospital Loop
Belcourt, ND 58316-0160

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
104061530ILMDWomen's Health Nurse Practitioner
CNM08603MDMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Quentin N Burdick Comprehensive Health Care Facility CurrentSince Dec 22, 2024 Accepting new patients

Locations

1300 Hospital Loop
Belcourt, ND 58316

4100 W 150th St
#3
Cleveland, OH 44135

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1831976059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 JOHN ST",
            "city": "ROLETTE",
            "state": "ND",
            "postal_code": "583667015",
            "telephone_number": "501-802-4641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 HOSPITAL LOOP",
            "city": "BELCOURT",
            "state": "ND",
            "postal_code": "583167712",
            "telephone_number": "701-477-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLIMAN",
        "first_name": "LARAY",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "CNM, WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": "104061530",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MD",
            "license": "CNM08603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belcourt, ND

Sources for this page

Verify at the official NPI Registry.