Active NPI
Robert L Holman, MD, FACC
- Cardiovascular Disease Physician
- Pueblo, CO
National Provider Identifier
1225083587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- DR.0050537
- Practice address
- 101 N Putnam Ave
Pueblo, CO 81005-1344 - Phone
- (208) 610-6392
- NPI assigned
- May 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | M-6477 | ID | |
| Cardiovascular Disease Physician | 207RC0000X | DR.0050537 | CO | Primary |
Addresses
Primary practice location
101 N Putnam Ave
Pueblo, CO 81005-1344
Mailing address
101 N Putnam Ave
Pueblo, CO 81005-1344
Phone (208) 610-6392
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003738300 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR.0050537 | CO | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHHS IHS Colville Service Unit | Current | Accepting new patients | |
| US Health Dept of Health & Human Services | Current | Accepting new patients | |
| US Health Dept of Health & Human Services | Current | Accepting new patients | |
| Omak Tribal Health Clinic | Current | Accepting new patients | |
| U S Health Dept of Health & Human Services | Current | Accepting new patients | |
| Flagstaff Medical Center | Past | Accepting new patients |
Locations
669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100
617 Benton St
Omak, WA 98841
Phone (509) 422-7416
Organizations & group practices 6
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.
-
- Critical Access Hospital
- Lodge Grass, MT
- NPI 1750410395
-
- Critical Access Hospital
- Crow Agency, MT
- NPI 1548393358
-
- General Acute Care Hospital
- Flagstaff, AZ
- NPI 1780635078
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398211200000",
"number": "1225083587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 N PUTNAM AVE",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810051344",
"telephone_number": "208-610-6392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 N PUTNAM AVE",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810051344",
"telephone_number": "208-610-6392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMAN",
"first_name": "ROBERT",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD, FACC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-24",
"last_updated": "2014-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "ID",
"license": "M-6477",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "CO",
"license": "DR.0050537",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003738300",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.