Active NPI
Peter Barkalow Holt, MD
- Internal Medicine Physician
- Longmont, CO
National Provider Identifier
1104907450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 19986
- 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.
-
- General Acute Care Hospital
- Longmont, CO
- NPI 1366465866
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
| License | State | Type | Specialty |
|---|---|---|---|
| 19986 | CO | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longmont United Hospital | Past | Accepting new patients |
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 19986 | CO | Primary |
Addresses
NPPES NPI RegistryPrimary 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| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04005930 | Medicaid | CO |
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.