Individual provider Active NPI

Stephen Holman, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Richmond, VA
National Provider Identifier
1104496629
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
0024181722 Issued in VA
Practice address
1250 E Marshall St
Richmond, VA 23298-5023
Phone
(804) 828-4620
Fax
(804) 628-0537
NPI assigned
Jun 28, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 0024181722 VA Primary

Addresses

Primary practice location

1250 E Marshall St
Richmond, VA 23298-5023

Mailing address

PO Box 780125
Philadelphia, PA 19178-0125
Phone (804) 922-4844

Other practice location 1

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7631

Other practice location 2

1213 E Clay St
Richmond, VA 23298-5071
Phone (804) 828-4620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211026002851 VA Practitioner - Nurse Practitioner 6901294818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

1200 E Marshall St
Richmond, VA 23298-5023
Phone (804) 828-9000

1250 E Marshall St
Richmond, VA 23298-5051

401 N 11TH St
Richmond, VA 23219-1914
Phone (804) 828-8737

Hospital & facility affiliations

  • Medical College of Virginia Hospitals Hospital, Richmond, VA, CCN 490032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024181722VAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians CurrentSince Nov 13, 2023 Accepting new patients

Locations

1250 E Marshall St
Richmond, VA 23298
Phone (804) 628-6990

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

1213 E Clay St
Richmond, VA 23298
Phone (804) 827-1207

Interoperability endpoints

  • Direct secure messaging: sholman20768@direct.carilionclinic.org

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1104496629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 780125",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191780125",
            "telephone_number": "804-922-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E MARSHALL ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985023",
            "telephone_number": "804-828-4620",
            "fax_number": "804-628-0537"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1906 Belleview Ave SE",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240141838",
            "country_code": "US",
            "telephone_number": "540-981-7631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1213 E Clay St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985071",
            "country_code": "US",
            "telephone_number": "804-828-4620",
            "fax_number": "804-628-0537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLMAN",
        "first_name": "STEPHEN",
        "credential": "AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-28",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024181722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.