Individual provider Active NPI

Zachary James Holm, PMHNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Moorhead, MN
National Provider Identifier
1851281414
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
13097 Issued in MN
Practice address
4000 28TH Ave S
Moorhead, MN 56560-7926
Phone
(701) 234-2000
NPI assigned
Jul 7, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X R50064 ND
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 13097 MN Primary

Addresses

Primary practice location

4000 28TH Ave S
Moorhead, MN 56560-7926

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-9419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250814003709 MN Practitioner - Nurse Practitioner 2062911373 Reassigns benefits to 1 organization
I20260121001168 ND Practitioner - Nurse Practitioner 2062911373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445

1412 Main St
Hawley, MN 56549
Phone (218) 483-3564

4000 28TH Ave S
Moorhead, MN 56560-7926
Phone (701) 234-3200

5225 23Rd Ave S
Fargo, ND 58104-7927
Phone (701) 417-2575

801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R50064NDMDAdult Psychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Jul 28, 2025 Accepting new patients
Sanford Medical Center Fargo CurrentSince Dec 10, 2025 Accepting new patients
Sanford Medical Center Fargo Current Accepting new patients
Sanford Medical Center Fargo CurrentSince Jul 28, 2025 Accepting new patients

Locations

4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200

801 Broadway N
Fargo, ND 58102
Phone (701) 234-5121

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1751846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1851281414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-9419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 28TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565607926",
            "telephone_number": "701-234-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLM",
        "first_name": "ZACHARY",
        "middle_name": "JAMES",
        "credential": "PMHNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-07",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "ND",
            "license": "R50064",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "13097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorhead, MN

Sources for this page

Verify at the official NPI Registry.