Active NPI
Shelly Welch Holmstrom, MD
- Obstetrics & Gynecology Physician
- Tampa, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- ME90448
- Practice address
- 4503 N 22ND St
Tampa, FL 33610-6201 - Phone
- (813) 738-6684
- Fax
- (813) 413-8549
- NPI assigned
- Aug 14, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | ME90448 | FL | Primary |
Addresses
Primary practice location
4503 N 22ND St
Tampa, FL 33610-6201
Mailing address
1410 Harbour Walk Rd
Tampa, FL 33602-5971
Phone (813) 394-1668
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 270375100 | Medicaid | FL | |
| 48546 | Other | FL | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- University of Florida College of Medicine, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13901 Bruce B Downs Blvd
Tampa, FL 33613-3905
Phone (813) 615-7260
14710 Bruce B Downs Blvd
Tampa, FL 33613-2800
Phone (813) 738-6691
2700 Healing Way
Wesley Chapel, FL 33543-5453
3100 E Fletcher Ave
Tampa, FL 33613-4613
Phone (813) 615-7075
4503 N 22ND St
Tampa, FL 33610-6201
Phone (813) 738-6684
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Hospital Physician Group Inc | Obstetrics & Gynecology | Current | Accepting new patients |
| DHP of Manatee PA | Obstetrics & Gynecology | Current | Accepting new patients |
Locations
1500 SW 1st Ave
Ocala, FL 34471
Phone (352) 351-7500
703 N Flamingo Rd
Pembroke Pnes, FL 33028
Phone (954) 436-5000
4503 N 22nd St
Tampa, FL 33610
Phone (813) 738-6684
2701 W Mlk Blvd
Tampa, FL 33607
Phone (813) 738-6690
13601 Bruce B Downs Blvd
Ste 260
Tampa, FL 33613
14710 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 738-6691
3100 E Fletcher Ave
Tampa, FL 33613
Phone (813) 615-7200
13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260
2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209
101 Avenue O SE
Winter Haven, FL 33880
Phone (863) 294-7010
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- sholmstrom1941727@adventhealth.direct-ci.com
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Tampa, FL
- NPI 1174955256
Obstetrics & Gynecology
-
- Obstetrics & Gynecology Physician
- Mangonia Park, FL
- NPI 1134771611
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Wesley Chapel, FL
- NPI 1073893020
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1053321919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698192000000",
"number": "1427061043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1410 HARBOUR WALK RD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336025971",
"telephone_number": "813-394-1668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4503 N 22ND ST",
"city": "TAMPA",
"state": "FL",
"postal_code": "336106201",
"telephone_number": "813-738-6684",
"fax_number": "813-413-8549"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMSTROM",
"first_name": "SHELLY",
"middle_name": "WELCH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-14",
"last_updated": "2023-10-25",
"certification_date": "2023-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "FL",
"license": "ME90448",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "270375100",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "48546",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.