Holly Lynn Gomez-Levine, APRN, CNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

7182-33 Issued in WI

Practice address

3500 Tower Ave
Superior, WI 54880-4491

Phone

(715) 817-7100

Fax

(406) 457-8992

NPI assigned

Jul 7, 2008

Last updated

May 22, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MT, WI2 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

Specialty

Nurse Practitioner

Education

Rush Medical College of Rush University, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Marys Hospital Superior Hospital, Superior, WI, CCN 521329

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

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.

• The Duluth Clinic, LTD

  dba Essentia Health Duluth Clinic

  • Multi-Specialty Clinic/Center
  • Duluth, MN
  • NPI 1245278209

  WI

  Medicare reassignment Care Compare group NPD
• St. Mary's Hospital of Superior

  dba Essentia Health St. Mary's Hospital Superior

  • Critical Access Hospital
  • Superior, WI
  • NPI 1083657886
  Medicare reassignment NPD
• Pureview Health Center

  • Federally Qualified Health Center (FQHC)
  • Helena, MT
  • NPI 1740390756
  Medicare reassignment NPD
• St. Mary's Hospital of Superior

  dba Essentia Health St. Mary's-Superior Clinic

  • Critical Access Hospital Clinic/Center
  • Superior, WI
  • NPI 1588691588
  NPD
• Pureview Health Center

  dba PureView HMS

  • Federally Qualified Health Center (FQHC)
  • Helena, MT
  • NPI 1831916659
  NPD
• Pureview Health Center

  dba PureView Health Center Downtown

  • Federally Qualified Health Center (FQHC)
  • Helena, MT
  • NPI 1891463048
  NPD
• The Duluth Clinic, LTD.

  dba Essentia Health Hinckley Pharmacy

  • Community/Retail Pharmacy
  • Hinckley, MN
  • NPI 1245081066
  NPD
• The Duluth Clinic, LTD

  dba Essentia Health Ashland Clinic

  • Multi-Specialty Clinic/Center
  • Ashland, WI
  • NPI 1215974357
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Mary's Hospital of Superior

  dba Essentia Health St. Mary's Hospital Superior

  • Critical Access Hospital
  • Superior, WI
  • NPI 1083657886
  Care Compare affiliation
• St. Mary's Hospital of Superior

  dba Essentia Health St. Mary's-Superior Clinic

  • Critical Access Hospital Clinic/Center
  • Superior, WI
  • NPI 1588691588
  Care Compare affiliation

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1881857167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 TOWER AVE",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548804491",
            "telephone_number": "715-817-7100",
            "fax_number": "406-457-8992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ-LEVINE",
        "first_name": "HOLLY",
        "middle_name": "LYNN",
        "credential": "APRN, CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-07",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MT",
            "license": "100926",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "7182-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE FOR C4MH",
            "identifier": "P01206032   C01340",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-SHIELD OF MONTANA",
            "identifier": "0000371733",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerald T Mikel Family Dentistry SC (Mikel Family Dentistry)
• Joel Wilhelm Getzke
• Lauren Elizabeth Giammar, MD
• Leslie Gibbs
• John William Gildersleeve
• Kathy Gore
• Kate N Graham, PHARMD
• Cindy Grahn, SAC-IT
• William George Grammond
• Great Lakes Rehabilitation and Nursing Center LLC (Dove Healthcare - Superior)

• Psychiatric/Mental Health Nurse Practitioner in Superior, WI
• Providers in Superior, WI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; 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.

Verify at the official NPI Registry.