Individual provider Active NPI

Brenda Mary Holland, D.C.

  • Chiropractor
  • Germantown, WI
National Provider Identifier
1992923163
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4044012 Issued in WI
Practice address
W164N11269 Squire Dr Ste B
Germantown, WI 53022-6017
Phone
(262) 250-1948
NPI assigned
Apr 23, 2007
Last updated
Dec 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4044012 WI Primary

Addresses

Primary practice location

W164N11269 Squire Dr Ste B
Germantown, WI 53022-6017

Mailing address

W164N11269 Squire Dr Ste B
Germantown, WI 53022-6017
Phone (262) 250-1948

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050720001156 WI Practitioner - Chiropractic 0840227898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

W164N11269 Squire Dr
Suite B
Germantown, WI 53022-6017
Phone (262) 250-1948

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4044012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Company - Germantown LTD Chiropractor CurrentSince Jan 1, 2012 Accepting new patients
Chiropractic Company S.C. Chiropractor Past Accepting new patients

Locations

W164N11269 Squire Dr
Ste B
Germantown, WI 53022
Phone (262) 250-1948

W164N11297 Squire Dr
Germantown, WI 53022
Phone (262) 250-1948

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1992923163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W164N11269 SQUIRE DR STE B",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530226017",
            "telephone_number": "262-250-1948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W164N11269 SQUIRE DR STE B",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530226017",
            "telephone_number": "262-250-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "BRENDA",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4044012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.