Individual provider Active NPI

Katherine Holdwick, FNP-C

  • Family Nurse Practitioner
  • Lenox, MI
National Provider Identifier
1912400136
Registry record updated Mar 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704273604 Issued in MI
Practice address
36267 26 Mile Rd Ste 3
Lenox, MI 48048-3253
Phone
(586) 716-1371
Fax
(586) 716-4855
NPI assigned
Mar 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704273604 MI Primary

Addresses

Primary practice location

36267 26 Mile Rd Ste 3
Lenox, MI 48048-3253

Mailing address

36267 26 Mile Rd Ste 3
Lenox, MI 48048-3253
Phone (586) 716-1371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180315002143 MI Practitioner - Nurse Practitioner 0042572711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Healthcare Network PCGroup PAC ID 3476456252, 30 clinicians

Practice addresses (Care Compare)

36267 26 Mile Rd
Suite 3
Lenox, MI 48048-3253
Phone (586) 716-1371

Hospital & facility affiliations

  • McLaren Macomb Hospital, Mount Clemens, MI, CCN 230227

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704273604MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Healthcare Network, PC Nurse Practitioner CurrentSince Mar 14, 2018 Accepting new patients

Locations

36267 26 Mile Rd
Ste 3
Lenox, MI 48048
Phone (586) 716-1371

3350 Gratiot Blvd
Marysville, MI 48040
Phone (810) 364-4000

Interoperability endpoints

  • Direct secure messaging: katherine.holdwick.1@11357.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520985600000",
    "number": "1912400136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36267 26 MILE RD STE 3",
            "city": "LENOX",
            "state": "MI",
            "postal_code": "480483253",
            "telephone_number": "586-716-1371",
            "fax_number": "586-716-4855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36267 26 MILE RD STE 3",
            "city": "LENOX",
            "state": "MI",
            "postal_code": "480483253",
            "telephone_number": "586-716-1371",
            "fax_number": "586-716-4855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDWICK",
        "first_name": "KATHERINE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-14",
        "last_updated": "2018-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704273604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenox, MI

Sources for this page

Verify at the official NPI Registry.