Individual provider Active NPI

James D Holt, M.D.

  • Family Medicine Physician
  • Johnson City, TN
National Provider Identifier
1104802909
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35631 Issued in TN
Practice address
917 W Walnut St
Johnson City, TN 37604
Phone
(423) 439-6464
Fax
(423) 439-7118
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35631 TN Primary

Addresses

Primary practice location

917 W Walnut St
Johnson City, TN 37604

Mailing address

P.O.Box 699
Mountain Home, TN 37684-0699
Phone (423) 439-6464

Other identifiers 1

IdentifierTypeStateIssuer
1508898MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080603000535 TN Practitioner - Family Practice 7719057736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Maryland School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Education Assistance CorporationGroup PAC ID 3870491269, 168 clinicians

Practice addresses (Care Compare)

917 W Walnut St
Johnson City, TN 37604-6527
Phone (423) 439-6464

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Johnson City, TN, CCN 447422
  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063
  • Franklin Woods Community Hospital Hospital, Johnson City, TN, CCN 440184

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11480SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Education Assistance Corporation Family Medicine CurrentSince Jun 15, 2008 Accepting new patients
Mountain States Health Alliance Past Accepting new patients

Locations

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

917 W Walnut St
Johnson City, TN 37604
Phone (423) 439-6464

222 E Main St
Johnson City, TN 37604
Phone (423) 433-6200

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1104802909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O.BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-439-6464",
            "fax_number": "423-439-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 W WALNUT ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "telephone_number": "423-439-6464",
            "fax_number": "423-439-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "JAMES",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "35631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508898",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.