Individual provider Active NPI

Sharon J. Martin Holm, M.D.

  • Family Medicine Physician
  • Tyler, TX
National Provider Identifier
1275538035
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K8657 Issued in TX
Practice address
11937 US Highway 271
Tyler, TX 75708-3154
Phone
(903) 877-7777
NPI assigned
Jun 17, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K8657 TX Primary

Addresses

Primary practice location

11937 US Highway 271
Tyler, TX 75708-3154

Mailing address

PO Box 731912
Dallas, TX 75373-1912
Phone (903) 877-7777

Other identifiers 2

IdentifierTypeStateIssuer
144947204MedicaidTX
144947205MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050218000495 TX Practitioner - Family Practice 8022060961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11937 US Hwy 271
Tyler, TX 75708-3154
Phone (903) 877-7200

Hospital & facility affiliations

  • Angels Care Home Health Home health agency, Palestine, TX, CCN 458433
  • University of Texas Health Science Center at Tyler Hospital, Tyler, TX, CCN 450690
  • Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
  • Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K8657TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at Tyler-Facilty-Physician CurrentSince Feb 1, 2018 Accepting new patients
University of Texas Health Science Center at Tyler-Facility-Physician CurrentSince Feb 1, 2018 Accepting new patients
April Gatson, MD Family Medicine Past Accepting new patients
Phynet, Inc. PastSince Apr 1, 2014 Accepting new patients

Locations

102 W Henderson St
Overton, TX 75684
Phone (903) 834-0201

11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451

3310 Patriot Dr
Tyler, TX 75701
Phone (903) 877-8925

Interoperability endpoints

  • Direct secure messaging: smartinholm346150@ahs.direct-ci.com

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1275538035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 731912",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753731912",
            "telephone_number": "903-877-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11937 US HIGHWAY 271",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757083154",
            "telephone_number": "903-877-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN HOLM",
        "first_name": "SHARON",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-17",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K8657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144947204",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144947205",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.