Active NPI
Holli Watkin, CNP
- Family Nurse Practitioner
- Independence, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 201909639NP-PP
- Practice address
- 1601 Monmouth St Ste 100
Independence, OR 97351-1019 - Phone
- (503) 838-0045
- NPI assigned
- Oct 29, 2012
- Last updated
- Mar 7, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 201909639NP-PP | OR | Primary |
Addresses
Primary practice location
1601 Monmouth St Ste 100
Independence, OR 97351-1019
Mailing address
10210 Bellingham Dr
Summerset, SD 57718-9271
Phone (605) 890-2517
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500772076 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD, OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
875 Oak St SE
Suite 5070
Salem, OR 97301-3998
Phone (503) 511-8565
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201909639NP-PP | OR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Monument Health Rapid City Hospital Inc | Current | Accepting new patients | |
| Monument Health Rapid City Hospital, Inc | Current | Accepting new patients | |
| Kidney Care Physicians LLC | Current | Accepting new patients | |
| Monument Health Rapid City Hospital, Inc. | Current | Accepting new patients | |
| Sanford Health | Past | Accepting new patients | |
| Salem Radiology Consultants PC | Past | Accepting new patients |
Locations
875 Oak St SE
Ste 5070
Salem, OR 97301
Phone (503) 442-9861
2116 Jackson Blvd
Rapid City, SD 57702
Phone (605) 755-3300
353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000
Interoperability endpoints
- hwatkin237338@direct.salemhealth.org
Organizations & group practices 6
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.
-
- Nephrology Physician
- Salem, OR
- NPI 1467672261
-
dba Monument Health Behavioral Health Center
- Multi-Specialty Clinic/Center
- Rapid City, SD
- NPI 1275553463
-
dba Monument Health Rapid Valley Clinic
- Urgent Care Clinic/Center
- Rapid City, SD
- NPI 1215727854
-
dba Monument Health Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Rapid City, SD
- NPI 1487621116
-
- Diagnostic Radiology Physician
- Salem, OR
- NPI 1649221813
-
- Clinic/Center
- Rapid City, SD
- NPI 1528313657
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Salem, OR
- NPI 1265431829
-
- Critical Access Hospital
- Dallas, OR
- NPI 1245237486
-
- General Acute Care Hospital
- Stayton, OR
- NPI 1154302214
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1851645931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10210 BELLINGHAM DR",
"city": "SUMMERSET",
"state": "SD",
"postal_code": "577189271",
"telephone_number": "605-890-2517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 MONMOUTH ST STE 100",
"city": "INDEPENDENCE",
"state": "OR",
"postal_code": "973511019",
"telephone_number": "503-838-0045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATKIN",
"first_name": "HOLLI",
"name_prefix": "Mrs.",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-29",
"last_updated": "2023-03-07",
"certification_date": "2019-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OR",
"license": "201909639NP-PP",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500772076",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Independence, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.