Individual provider Active NPI

Thomas J Holcomb III, MD

  • Anesthesiology Physician
  • Richland, WA
National Provider Identifier
1124099437
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
60187979 Issued in WA
Practice address
888 Swift Blvd.
Richland, WA 99352-3514
Phone
(509) 942-2931
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 16236 TN
Anesthesiology Physician 207L00000X 60187979 WA Primary

Addresses

Primary practice location

888 Swift Blvd.
Richland, WA 99352-3514

Mailing address

427 Columbia Point Dr.
Richland, WA 99352-4373
Phone (901) 299-9644

Other identifiers 7

IdentifierTypeStateIssuer
00095885MedicaidMS
92418OtherARBLUECROSS BLUESHIELD
50046018OtherMEDICARE TRAVELERS
3014312MedicaidTN
112943001MedicaidAR
203461900MedicaidMO
3072113OtherTNBLUECROSS BLUESHIELD

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
16236TNMDAnesthesiology Physician
60187979WAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Anesthesia of Richland a Division of Premier Anesthesia, LLC Anesthesiology Past Accepting new patients

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1124099437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 COLUMBIA POINT DR.",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524373",
            "telephone_number": "901-299-9644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 SWIFT BLVD.",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523514",
            "telephone_number": "509-942-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLCOMB",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "16236",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "60187979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00095885",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "92418",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE TRAVELERS",
            "identifier": "50046018",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3014312",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112943001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203461900",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "3072113",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; 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.