Chase Holtman

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.016758 Issued in IL

Practice address

615 N Promenade St
Havana, IL 62644-1243

Phone

(309) 543-6600

Fax

(309) 543-2089

NPI assigned

Oct 19, 2017

Last updated

Oct 19, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mason Hospital DistrictGroup PAC ID 2466360607, 41 clinicians

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chase.holtman@hmamdh.eclinicaldirectplus.com

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.

• Mason Hospital District

  dba Mason District Hospital

  • Critical Access Hospital
  • Havana, IL
  • NPI 1902849649
  Medicare reassignment Care Compare group NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Mason Hospital District

  dba Mason District Hospital

  • Critical Access Hospital
  • Havana, IL
  • NPI 1710181797
  NPD
• Mason Hospital District

  dba Manito Medical Associates

  • Family Medicine Physician
  • Manito, IL
  • NPI 1902340748
  NPD
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Mason Hospital District

  dba Manito Medical Associates

  • Rural Health Clinic/Center
  • Manito, IL
  • NPI 1780128512
  NPD (past)

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

{
    "created_epoch": "1508371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508371200000",
    "number": "1912418799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 N PROMENADE ST",
            "city": "HAVANA",
            "state": "IL",
            "postal_code": "626441243",
            "telephone_number": "309-543-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N PROMENADE ST",
            "city": "HAVANA",
            "state": "IL",
            "postal_code": "626441243",
            "telephone_number": "309-543-6600",
            "fax_number": "309-543-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTMAN",
        "first_name": "CHASE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-19",
        "last_updated": "2017-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.016758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Havana Hco, LLC (Havana Health Care Center)
• Havana Hco, LLC
• Alycia Helling, M.S., CCC-SLP
• Stuart Hickerson
• Highland Park CVS LLC (CVS Pharmacy # 07610)
• HSHS Medical Group Inc
• Justin Huggins
• Jenna Elizabeth Ishmael, FNP-C
• Marsha R Kirchner, CF-NP
• Kelsey Elizabeth Knake

• Family Nurse Practitioner in Havana, IL
• Providers in Havana, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; 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.