Active NPI
Julia Holsomback, APRN
- Family Nurse Practitioner
- Jacksonville, FL
National Provider Identifier
1083179816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 9424941
- Practice address
- 11481 Old Saint Augustine Rd
Jacksonville, FL 32258-1473 - Phone
- (904) 633-0210
- NPI assigned
- Feb 6, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 9424941 | FL | Primary |
Addresses
Primary practice location
11481 Old Saint Augustine Rd
Jacksonville, FL 32258-1473
Mailing address
12623 Shady Creek Dr
Jacksonville, FL 32223-2030
Phone (678) 662-4622
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9424941 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cowry Medical Group, LLC | Current | Accepting new patients |
Locations
4450 Calibre Xing NW
Ste 1126
Acworth, GA 30101
Phone (470) 227-8130
1720 Mars Hill Rd NW
Ste 120380
Acworth, GA 30101
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 and National Provider Directory roles.
-
- Nephrology Physician
- Acworth, GA
- NPI 1730688490
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549411200000",
"number": "1083179816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12623 SHADY CREEK DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322232030",
"telephone_number": "678-662-4622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11481 OLD SAINT AUGUSTINE RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322581473",
"telephone_number": "904-633-0210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLSOMBACK",
"first_name": "JULIA",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-06",
"last_updated": "2019-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "9424941",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.