Individual provider Active NPI

John David Holcomb, M.D.

  • Facial Plastic Surgery Physician
  • Sarasota, FL
National Provider Identifier
1124025267
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
ME80017 Issued in FL
Practice address
1 S School Ave
Suite 800
Sarasota, FL 34237-6045
Phone
(941) 365-8679
Fax
(941) 365-8680
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X ME80017 FL Primary

Addresses

Primary practice location

1 S School Ave
Suite 800
Sarasota, FL 34237-6045

Mailing address

1 S School Ave Ste 800
Sarasota, FL 34237-6045
Phone (941) 365-8679

Other identifiers 1

IdentifierTypeStateIssuer
ME80017OtherFLFLORIDA MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110411000629 FL Practitioner - Plastic and Reconstructive SurgeryPractitioner - OtolaryngologyPractitioner - Sports Medicine 2466636733

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Holcomb Kreithen Plastic Surgery & Medspa PLLC Current Accepting new patients

Locations

1 S School Ave
Ste 800
Sarasota, FL 34237
Phone (941) 365-8679

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1124025267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 S SCHOOL AVE STE 800",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342376045",
            "telephone_number": "941-365-8679",
            "fax_number": "941-365-8680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S SCHOOL AVE",
            "address_2": "SUITE 800",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342376045",
            "telephone_number": "941-365-8679",
            "fax_number": "941-365-8680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLCOMB",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "FL",
            "license": "ME80017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA MEDICAL LICENSE",
            "identifier": "ME80017",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.