Paige C Holt, MD, LTD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

036116185 Issued in IL

Legal business name

PAIGE C HOLT, MD, LTD

Practice address

2502 E Empire St
Suite C
Bloomington, IL 61704-3738

Phone

(309) 664-4444

NPI assigned

Jun 13, 2013

Last updated

Jun 13, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Paige C Holt, MDNPI 1821026519

Title

President

Phone

(217) 414-5342

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Paige C. Holt, MD

  • Plastic Surgery Physician
  • Bloomington, IL
  • NPI 1821026519
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371081600000",
    "number": "1295173128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 E EMPIRE ST",
            "address_2": "SUITE C",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043738",
            "telephone_number": "309-664-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 E EMPIRE ST",
            "address_2": "SUITE C",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043738",
            "telephone_number": "309-664-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIGE C HOLT, MD, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-13",
        "last_updated": "2013-06-13",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "PAIGE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-414-5342",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": "036116185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036116185",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Constance D Owens-Mooney, LCPC
• Angelina C Owens
• Caroline Owens, DMD
• Pacalo LLC
• Jacob Bradley Page, A.C.N.P.
• Paige C. Holt
• Andrea Palmer, OTD
• N'Dia Palmore
• Janell Kay Park, APRN, FNP
• Meghan Park, PT, DPT

• Plastic Surgery Physician in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Plastic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; 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.

Verify at the official NPI Registry.