Individual provider Active NPI

Anthony Paul Holst

  • Sports Medicine (Family Medicine) Physician
  • West Branch, MI
National Provider Identifier
1124681804
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
5101028281 Issued in MI
Practice address
640 Court St
West Branch, MI 48661-9390
Phone
(989) 345-7474
NPI assigned
Apr 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Sports Medicine (Family Medicine) Physician 207QS0010X 5101028281 MI Primary

Addresses

Primary practice location

640 Court St
West Branch, MI 48661-9390

Mailing address

4000 Wellness Dr
Midland, MI 48670-2000

Other practice location 1

27100 Chardon Rd
Richmond Heights, OH 44143-1192
Phone (801) 404-4154

Other practice location 2

3705 Olentangy River Rd Ste 260
Columbus, OH 43214-3467
Phone (614) 533-6611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240913003485 MI Practitioner - Sports Medicine 1557694379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Lake Erie Col of Osteo Med at Seton Hill Univ, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Progress Physical Therapy IncGroup PAC ID 5698669919, 23 clinicians
Mymichigan Medical Center West BranchGroup PAC ID 7214251081, 75 clinicians

Practice addresses (Care Compare)

3076 Northridge Rd
Hale, MI 48739-9277
Phone (989) 728-0242

640 Court St
West Branch, MI 48661-9390
Phone (989) 345-8170

Hospital & facility affiliations

  • Mymichigan Medical Center West Branch Hospital, West Branch, MI, CCN 230095
  • Mymichigan Medical Center Gladwin Hospital, Gladwin, MI, CCN 231325
  • Mymichigan Medical Center Clare Hospital, Clare, MI, CCN 230180

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.92
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center West Branch Current Accepting new patients
Mymichigan Medical Center West Branch CurrentSince Oct 28, 2024 Accepting new patients
West Branch Regional Medical Center Current Accepting new patients

Locations

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

2463 S M 30
West Branch, MI 48661
Phone (517) 345-3660

640 Court St
West Branch, MI 48661
Phone (989) 343-3730

Organizations & group practices 4

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 4

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": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1124681804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 COURT ST",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "486619390",
            "telephone_number": "989-345-7474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27100 Chardon Rd",
            "address_purpose": "LOCATION",
            "city": "Richmond Heights",
            "state": "OH",
            "postal_code": "441431192",
            "country_code": "US",
            "telephone_number": "801-404-4154",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3705 Olentangy River Rd Ste 260",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432143467",
            "country_code": "US",
            "telephone_number": "614-533-6611",
            "fax_number": "614-566-1429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLST",
        "first_name": "ANTHONY",
        "middle_name": "PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-17",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MI",
            "license": "5101028281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Branch, MI

Sources for this page

Verify at the official NPI Registry.