Individual provider Active NPI

Timothy Lynn Holcomb, D.C., FNP

  • Family Nurse Practitioner
  • Victoria, TX
National Provider Identifier
1407159544
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP130832 Issued in TX
Practice address
2601 N Azalea St
Suite 31
Victoria, TX 77901-4146
Phone
(361) 485-0449
NPI assigned
Dec 13, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 10365 TX
Chiropractor 111N00000X 5853 FL
Chiropractor 111N00000X 1660 NC
Family Nurse Practitioner 363LF0000X AP130832 TX Primary

Addresses

Primary practice location

2601 N Azalea St
Suite 31
Victoria, TX 77901-4146

Mailing address

2601 N Azalea St
Suite 31
Victoria, TX 77901-4146
Phone (361) 485-0449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200430001858 TX Practitioner - Nurse Practitioner 0446452320 Practice locations: Victoria, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5853FLMDOptician
1660NCMDPhysical Therapy Assistant
AP130832TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
C1C2 PLLC Chiropractor PastSince Mar 3, 2018 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486598400000",
    "number": "1407159544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 N AZALEA ST",
            "address_2": "SUITE 31",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779014146",
            "telephone_number": "361-485-0449",
            "fax_number": "361-485-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 N AZALEA ST",
            "address_2": "SUITE 31",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779014146",
            "telephone_number": "361-485-0449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLCOMB",
        "first_name": "TIMOTHY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C., FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-13",
        "last_updated": "2017-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "10365",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "5853",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "1660",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP130832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

Verify at the official NPI Registry.