Individual provider Active NPI

Victoria Jean Holcomb, PA

  • Physician Assistant
  • Glenwood Springs, CO
National Provider Identifier
1073841870
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0005869 Issued in CO
Practice address
1906 Blake Ave
Glenwood Springs, CO 81601-4227
Phone
(970) 384-7140
Fax
(970) 384-8133
NPI assigned
Dec 7, 2009
Last updated
Jul 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0005869 CO Primary

Addresses

Primary practice location

1906 Blake Ave
Glenwood Springs, CO 81601-4227

Mailing address

541 E 71St St
New York, NY 10021-4871
Phone (212) 606-1128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
014127NYMDMental Health Counselor
PA.0005869COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Steadman Clinic Professional LLC Past Accepting new patients

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, 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": "1260144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1073841870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 E 71ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214871",
            "telephone_number": "212-606-1128",
            "fax_number": "212-606-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 BLAKE AVE",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014227",
            "telephone_number": "970-384-7140",
            "fax_number": "970-384-8133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLCOMB",
        "first_name": "VICTORIA",
        "middle_name": "JEAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-07",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0005869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenwood Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.