Individual provider Active NPI

Miriam Williams Holcomb, FNP-C

  • Family Nurse Practitioner
  • Gastonia, NC
National Provider Identifier
1366973372
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5006436 Issued in NC
Practice address
2544 Court Dr Ste a
Gastonia, NC 28054-3450
Phone
(704) 671-6400
Fax
(704) 671-6449
NPI assigned
Mar 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 164519 NC
Family Nurse Practitioner 363LF0000X 5006436 NC Primary

Addresses

Primary practice location

2544 Court Dr Ste a
Gastonia, NC 28054-3450

Mailing address

PO Box 744786
Atlanta, GA 30374-4786
Phone (704) 834-2450

Other practice location 1

4235 S New Hope Rd Ste J
Gastonia, NC 28056-8453
Phone (704) 671-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170615001022 NC Practitioner - Nurse Practitioner 2264700244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

2544 Court Dr
Suite a
Gastonia, NC 28054-3450
Phone (704) 671-6400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5006436NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc CurrentSince May 15, 2017 Accepting new patients
Caromont Medical Group Inc CurrentSince May 15, 2017 Accepting new patients
Caromont Medical Group Inc Current Accepting new patients

Locations

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

2544 Court Dr
Ste A
Gastonia, NC 28054
Phone (704) 671-6400

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

2240 Remount Rd
Gastonia, NC 28054
Phone (704) 671-5311

4235 S New Hope Rd
Ste J
Gastonia, NC 28056
Phone (704) 671-6400

Organizations & group practices 3

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 2

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": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1366973372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744786",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744786",
            "telephone_number": "704-834-2450",
            "fax_number": "704-671-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2544 COURT DR STE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280543450",
            "telephone_number": "704-671-6400",
            "fax_number": "704-671-6449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4235 S New Hope Rd Ste J",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280568453",
            "country_code": "US",
            "telephone_number": "704-671-6400",
            "fax_number": "704-671-6449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLCOMB",
        "first_name": "MIRIAM",
        "middle_name": "WILLIAMS",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-22",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "164519",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5006436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.