Holly Mantych

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

129939 Issued in CO

Practice address

3303 . Broadway
Boulder, CO 80304

Phone

(303) 449-6050

NPI assigned

May 7, 2007

Last updated

Jul 16, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Clinica Campesina Family Health Services

  dba Clinica Family Health

  • Clinic/Center
  • Boulder, CO
  • NPI 1184613234
  NPD (past)
• Clinica Campesina Family Health Services

  dba Clinica Family Health and Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Longmont, CO
  • NPI 1558109223
  NPD (past)

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1881807089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 PLAZA CT N",
            "address_2": "1A",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263531",
            "telephone_number": "303-449-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 . BROADWAY",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "80304",
            "telephone_number": "303-449-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTYCH",
        "first_name": "HOLLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "129939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "129939",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Manor Care of Boulder Co, LLC (ProMedica Skilled Nursing and Rehabilitation (Boulder))
• Manorcare Health Services Boulder
• Jose Edmundo Manrique Mercado, MD
• Melissa Anne Holland Mansika, MS
• Ines Manteuffel, LMT
• Sandra Manzo
• Jie Mao, M.D.
• Madeline Christine Mapes
• Mapleton Hill Orthopaedics PC
• Mapleton OT

• Registered Nurse in Boulder, CO
• Providers in Boulder, CO by specialty
• Registered Nurse in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.