Holly Wruck Inc

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

HOLLY WRUCK INC

Practice address

7201 Metro Blvd Ste 550
Edina, MN 55439-1353

Phone

(612) 234-5304

NPI assigned

Jan 31, 2025

Organization subpart

No

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

Authorized official

Name

Holly Wruck, MS, RDN, LDNPI 1659736445

Title

Owner

Phone

(612) 234-5304

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Holly Wruck, R.D., L.D.

  • Registered Dietitian
  • Edina, MN
  • NPI 1659736445

  Dietitian, Registered, MN

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1738281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738281600000",
    "number": "1962215004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S 1ST ST UNIT 1704",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554012571",
            "telephone_number": "763-670-0806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7201 METRO BLVD STE 550",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554391353",
            "telephone_number": "612-234-5304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY WRUCK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-31",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A",
        "authorized_official_last_name": "WRUCK",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-234-5304",
        "authorized_official_credential": "MS, RDN, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Robert Holland, O.D.
• Lisa Hollensteiner, MD
• Aaron Thomas Holley, MD
• Brian Holloway, MD
• Holly E. Johnson, P.H.D.,P.a.
• Rachel Katherine Holm, D.D.S.
• Kristin Holmvik, PT, DPT
• David Carl Holte, M.D.
• Katherine A Holten, M.D.
• Tanya Holthus, PSY.D., L.P.

• All providers in Edina, MN
• Registered Dietitian in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.