JENNIFER HOLM – Family Nurse Practitioner, NPI 1265881841
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,720 NURSE PRACTITIONER in MN
Provider Addresses for JENNIFER HOLM
8170 Old Carriage Ct Ste 100
Shakopee, MN 553793164
Phone: (952) 428-3600
Fax: (952) 428-3636
Type: Location
165 W Commerce Dr
Belle Plaine, MN 560112911
Phone: (952) 442-2191
Type: Location
Mankato Clinic, 1230, East Main Street, High Ciara, Mankato, Blue Earth County, Minnesota, 56001, United States
MANKATO, MN 560015066
Phone: (507) 625-1811
Fax: (507) 389-8576
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $480.
Total Amount is formed as General ($480) + Research ($0) + Ownership ($0) = $480.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: ABBVIE INC. ($343).
Total Amount
$480
General + Research + Ownership
Payments
8
Total payment records
General Amount
$480
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $343 |
| Galderma Laboratories, L.P. | $137 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2016-08-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160801000198 | I | Nurse Practitioner | MN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 15 | 15 | $0 |
Insurance plans in this area (ZIP 55379)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | MN | |
| - | MN | |
| Emergency Medicine | MN | |
| Emergency Medicine, Peripheral Vascular Disease | MN | |
| Physician Assistant | VA | |
| Physician Assistant | MN | |
| Emergency Medicine | MN | |
| - | MN | |
| Emergency Medicine, Pediatric Medicine | MN | |
| Emergency Medicine | MN |
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