Individual provider Active NPI

John Plummer Holt, M.D.

  • Specialist
  • Raleigh, NC
National Provider Identifier
1477524783
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
31724 Issued in NC
Practice address
2600 Atlantic Ave
Raleigh, NC 27604-1502
Phone
(919) 881-9999
Fax
(919) 881-9998
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 31724 NC Primary

Addresses

Primary practice location

2600 Atlantic Ave
Raleigh, NC 27604-1502

Mailing address

540 Vista del Lago LN
Wake Forest, NC 27587-5340
Phone (919) 664-2867

Other identifiers 1

IdentifierTypeStateIssuer
8942977MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address johnholt@tg.allscriptsdirect.net

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100812000218 NC Practitioner - GastroenterologyPractitioner - Internal Medicine 9436253838 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31724NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Triangle Gastroenterology PLLC Specialist CurrentSince Jan 1, 1996 Accepting new patients
Midtown Raleigh Anesthesia PastSince Apr 2, 2020 Accepting new patients

Locations

2600 Atlantic Ave
#100
Raleigh, NC 27604
Phone (919) 881-9999

2600 Atlantic Ave
Raleigh, NC 27604
Phone (919) 881-9999

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/60532

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.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1477524783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 VISTA DEL LAGO LN",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275875340",
            "telephone_number": "919-664-2867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 ATLANTIC AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276041502",
            "telephone_number": "919-881-9999",
            "fax_number": "919-881-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "JOHN",
        "middle_name": "PLUMMER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "31724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8942977",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "johnholt@tg.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "2600 Atlantic Ave",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276041502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.