Active NPI
Shawn Holsonback, DO
- Emergency Medicine Physician
- Dalton, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 045242
- Practice address
- 1200 Memorial Dr
Dalton, GA 30720-2529 - Phone
- (706) 272-6000
- NPI assigned
- Aug 11, 2006
- Last updated
- Nov 14, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 045242 | GA | Primary |
Addresses
Primary practice location
1200 Memorial Dr
Dalton, GA 30720-2529
Mailing address
PO Box 636019
Cincinnati, OH 45263-6019
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00255537 | Other | GA | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- West Virginia School of Osteopathic Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
421 S Main St
Crossville, TN 38555-5031
Phone (931) 484-9511
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Coverage, LLC | Emergency Medicine | Current | Accepting new patients |
| Emergency Medicine Services of TN, PC | Emergency Medicine | Current | Accepting new patients |
| Emergency Coverage Services, PC | Past | Accepting new patients |
Locations
1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115
100 Gross Crescent Cir
Ft Oglethorpe, GA 30742
Phone (706) 858-2301
7402 Lee Hwy
Chattanooga, TN 37421
Phone (423) 242-9750
421 S Main St
Crossville, TN 38555
Phone (931) 260-1465
7900 Rhea County Hwy
Dayton, TN 37321
Phone (423) 570-0018
1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244
2300 Patterson St
Nashville, TN 37203
Phone (615) 342-1500
Interoperability endpoints
- sholsonback18523@hhcs.direct-ci.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Emergency Coverage Corporation of TeamHealth
- Family Medicine Physician
- Newport, TN
- NPI 1427005008
Emergency Medicine, GA
-
- Emergency Medicine Physician
- Nashville, TN
- NPI 1720785884
-
- Nurse Practitioner
- Lawrenceburg, TN
- NPI 1053351593
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Dalton, GA
- NPI 1528056066
-
- Psychiatric Hospital Unit
- Dalton, GA
- NPI 1760645782
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194998400000",
"number": "1396756680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 636019",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452636019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 MEMORIAL DR",
"city": "DALTON",
"state": "GA",
"postal_code": "307202529",
"telephone_number": "706-272-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLSONBACK",
"first_name": "SHAWN",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2007-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "GA",
"license": "045242",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00255537",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dalton, GA
- Grace Roberts Holcomb, NP
- Karissa Breanna Michelle Holcomb, FNP-BC
- Sara Holcomb, FNP
- Deirdre Anne Holden, RN
- Oscar Holliday
- Home Health Care Rentals Inc
- Home Health Care Rentals, Inc.
- Homestead Hospice of Northwest Georgia, LLC (Eternal Faith Hospice and Palliative Care)
- Homestead Hospice of Northwest Georgia, LLC (Eternal Faith Hospice and Palliative Care)
- Adam Charles Horne, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.