Individual provider Active NPI

Peter Barkalow Holt, MD

  • Internal Medicine Physician
  • Longmont, CO
National Provider Identifier
1104907450
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
19986 Issued in CO
Practice address
2030 W Mountain View Avenue
Suite 400
Longmont, CO 80501-3178
Phone
(303) 776-1532
Fax
(303) 776-3109
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

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.

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19986COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Longmont United Hospital Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 19986 CO Primary

Addresses

NPPES NPI Registry

Primary practice location

2030 W Mountain View Avenue
Suite 400
Longmont, CO 80501-3178

Mailing address

2030 W Mountain View Avenue
Suite 400
Longmont, CO 80501-3178
Phone (303) 776-1532

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
04005930MedicaidCO

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104907450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 W MOUNTAIN VIEW AVENUE",
            "address_2": "SUITE 400",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013178",
            "telephone_number": "303-776-1532",
            "fax_number": "303-776-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 W MOUNTAIN VIEW AVENUE",
            "address_2": "SUITE 400",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013178",
            "telephone_number": "303-776-1532",
            "fax_number": "303-776-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "PETER",
        "middle_name": "BARKALOW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "19986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04005930",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.