Individual provider Active NPI

Clinton Fay Holland, DPM

  • Podiatrist
  • Englewood, CO
National Provider Identifier
1184672081
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
660 Issued in CO
Practice address
601 E Hampden Ave
#410
Englewood, CO 80113-3781
Phone
(303) 789-9255
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2008

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 660 CO Primary
Public Medicine Podiatrist 213EP0504X 660 CO
Primary Podiatric Medicine Podiatrist 213EP1101X 660 CO
Radiology Podiatrist 213ER0200X 660 CO
Sports Medicine Podiatrist 213ES0000X 660 CO
Foot & Ankle Surgery Podiatrist 213ES0103X 660 CO

Addresses

Primary practice location

601 E Hampden Ave
#410
Englewood, CO 80113-3781

Mailing address

601 E Hampden Ave
#410
Englewood, CO 80113-3781
Phone (303) 789-9255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20060915000100 CO Practitioner - PodiatryPractitioner - NeurosurgeryPractitioner - Orthopedic Surgery 1759386246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PodiatryAlso: Neurosurgery, Orthopedic Surgery
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

601 E Hampden Ave
Englewood, CO 80113-2770
Phone (303) 789-9255

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
660COMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Footcare, PC CurrentSince Jun 19, 2006 Accepting new patients

Locations

601 E Hampden Ave
Ste 410
Englewood, CO 80113
Phone (303) 781-1300

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213056000000",
    "number": "1184672081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E HAMPDEN AVE",
            "address_2": "#410",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801133781",
            "telephone_number": "303-789-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E HAMPDEN AVE",
            "address_2": "#410",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801133781",
            "telephone_number": "303-789-9255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "CLINTON",
        "middle_name": "FAY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2008-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CO",
            "license": "660",
            "primary": true
        },
        {
            "code": "213EP0504X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Public Medicine",
            "state": "CO",
            "license": "660",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "CO",
            "license": "660",
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "CO",
            "license": "660",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "CO",
            "license": "660",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CO",
            "license": "660",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

Verify at the official NPI Registry.