Individual provider Active NPI

Caleb Holder

  • Family Medicine Physician
  • West Des Moines, IA
National Provider Identifier
1336700830
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO-06358 Issued in IA
Practice address
5950 University Ave Ste 220
West Des Moines, IA 50266-8231
Phone
(515) 875-9410
Fax
(515) 875-9412
NPI assigned
Jun 25, 2019
Last updated
Dec 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 94-10060 KS
Family Medicine Physician 207Q00000X DO-06358 IA Primary

Addresses

Primary practice location

5950 University Ave Ste 220
West Des Moines, IA 50266-8231

Mailing address

PO Box 424
Des Moines, IA 50302-0424
Phone (515) 875-9255

Other practice location 1

1010 N Kansas St
Wichita, KS 67214-3124
Phone (316) 858-3460

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address calebholder@tic.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20230725000428 IA Practitioner - Family Practice 3072849728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Alabama College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Iowa Clinic PCGroup PAC ID 4082513742, 307 clinicians

Practice addresses (Care Compare)

5950 University Ave
Suite 220
West Des Moines, IA 50266-8231
Phone (515) 875-9100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Iowa Clinic PC Family Medicine CurrentSince Sep 11, 2023 Accepting new patients
The Iowa Clinic, PC CurrentSince Sep 11, 2023 Accepting new patients

Locations

1005 Pennsylvania Ave
Ste 102A
Ottumwa, IA 52501
Phone (641) 684-2589

5950 University Ave
Ste 220
West Des Moines, IA 50266
Phone (515) 875-9410

Interoperability endpoints

  • Direct secure messaging: calebholder@tic.allscriptsdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1336700830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 424",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503020424",
            "telephone_number": "515-875-9255",
            "fax_number": "515-875-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5950 UNIVERSITY AVE STE 220",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668231",
            "telephone_number": "515-875-9410",
            "fax_number": "515-875-9412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 N Kansas St",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672143124",
            "country_code": "US",
            "telephone_number": "316-858-3460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLDER",
        "first_name": "CALEB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-25",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "94-10060",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "DO-06358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "calebholder@tic.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5950 University Ave Ste 220",
            "city": "West Des Moines",
            "state": "IA",
            "country_code": "US",
            "postal_code": "502668231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.