Individual provider Active NPI

James Blake Holloway, MD

  • Family Medicine Physician
  • Cabot, AR
National Provider Identifier
1194288662
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-15470 Issued in AR
Practice address
2037 W Main St
Cabot, AR 72023-7479
Phone
(501) 843-4555
NPI assigned
Apr 10, 2019
Last updated
Jul 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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 NU
Family Medicine Physician 207Q00000X E-15470 AR Primary

Addresses

Primary practice location

2037 W Main St
Cabot, AR 72023-7479

Mailing address

2037 W Main St
Cabot, AR 72023-7479
Phone (501) 843-4555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20220714002852 AR Practitioner - Family Practice 9032452776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2037 W Main St
Cabot Medical Care
Cabot, AR 72023-7479
Phone (501) 843-4555

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Central Primary Care, PLLC Family Medicine CurrentSince Jul 11, 2022 Accepting new patients
Arkansas Central Primary Care PLLC Family Medicine CurrentSince Jul 11, 2022 Accepting new patients
Physicians Network Inc Dba Cabot Medical Clinic Family Medicine Past Accepting new patients
Physicians Network Inc. Family Medicine Past Accepting new patients

Locations

2037 W Main St
Cabot, AR 72023
Phone (501) 843-4555

1300 Braden St
Jacksonville, AR 72076
Phone (501) 985-5900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1194288662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2037 W MAIN ST",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "720237479",
            "telephone_number": "501-843-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2037 W MAIN ST",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "720237479",
            "telephone_number": "501-843-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "JAMES",
        "middle_name": "BLAKE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-10",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-15470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cabot, AR

Sources for this page

Verify at the official NPI Registry.