NPIMap

Individual provider Active NPI

Alfred John Holm, MD

  • Family Medicine Physician
  • Ocean Shores, WA
National Provider Identifier
1326123555
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00042371 Issued in WA
Practice address
597 Point Brown Ave NW
Ocean Shores, WA 98569
Phone
(360) 289-4151
Fax
(360) 289-4693
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MD00042371 WA Primary

Addresses

Primary practice location

597 Point Brown Ave NW
Ocean Shores, WA 98569

Mailing address

PO Box 1569
Ocean Shores, WA 98569-1569
Phone (360) 289-4151

Other identifiers 1

IdentifierTypeStateIssuer
1118736MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250516001012 TX Practitioner - Family Practice 4789580333 Reassigns benefits to 1 organization
I20260317003004 MT Practitioner - Emergency Medicine 4789580333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice
Education
Oregon Health Sciences University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Cheyenne Ave
Lame Deer, MT 59043-0000
Phone (406) 477-4451

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00042371WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
U S Health Dept of Health & Human Services CurrentSince Jun 23, 2022 Accepting new patients
Coastal Family Medicine Inc. P.S. Family Medicine CurrentSince Oct 10, 2003 Accepting new patients
US Dept of HHS Family Medicine CurrentSince Feb 27, 2025 Accepting new patients
U S Health Dept of Health & Human Services CurrentSince Jun 23, 2022 Accepting new patients
US Health Dept of Health & Human Services Current Accepting new patients
Pacific County Hospital District 2 Past Accepting new patients
Clallam County Public Hospital District No 1 Family Medicine Past Accepting new patients

Locations

669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100

453 Pine Grove Rd
Hays, MT 59527
Phone (406) 353-3190

597 Point Brown Ave NW
Ocean Shores, WA 98569
Phone (360) 289-2427

Organizations & group practices 8

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326123555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1569",
            "city": "OCEAN SHORES",
            "state": "WA",
            "postal_code": "985691569",
            "telephone_number": "360-289-4151",
            "fax_number": "360-289-4693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "597 POINT BROWN AVE NW",
            "city": "OCEAN SHORES",
            "state": "WA",
            "postal_code": "98569",
            "telephone_number": "360-289-4151",
            "fax_number": "360-289-4693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLM",
        "first_name": "ALFRED",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00042371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1118736",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean Shores, WA

Sources for this page

Verify at the official NPI Registry.