Individual provider Active NPI

Victoria Lewis-Holland, D.O.

  • General Acute Care Hospital
  • Bainbridge, GA
National Provider Identifier
1487721718
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
041156 Issued in GA
Practice address
1500 E Shotwell St
Bainbridge, GA 39819-4256
Phone
(229) 246-3500
NPI assigned
Nov 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 041156 GA Primary

Addresses

Primary practice location

1500 E Shotwell St
Bainbridge, GA 39819-4256

Mailing address

1500 E Shotwell St
Bainbridge, GA 39819-4256
Phone (229) 246-3500

Other identifiers 1

IdentifierTypeStateIssuer
000582909NMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040715000707 GA Practitioner - Emergency Medicine 5193704963 Reassigns benefits to 2 organizations
I20190923002513 AL Practitioner - General PracticePractitioner - Emergency Medicine 5193704963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Philadelphia College of Osteopathic Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Donalsonville Hospital IncGroup PAC ID 7113919820, 63 clinicians

Practice addresses (Care Compare)

102 Hospital Cir
Donalsonville, GA 39845-1100
Phone 2295245217218

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041156GAMDGeneral Acute Care Hospital

Practice roles

OrganizationSpecialtyStatusNew patients
Quality of Life Health Services, Inc Current Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County General Acute Care Hospital CurrentSince Sep 25, 2003 Accepting new patients
Quality of Life Health Services Inc Current Accepting new patients
Quality of Life Health Services, Inc CurrentSince Jul 6, 2019 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Georgi CurrentSince Sep 25, 2003 Accepting new patients
Donalsonville Hospital Inc CurrentSince Jul 29, 2017 Accepting new patients
Quality of Life Health Services, Inc CurrentSince Jul 6, 2019 Accepting new patients
Drexis, LLC. Past Accepting new patients
Sterling Emergency Services of the Southeast Inc Past Accepting new patients

Locations

1411 Piedmont Cutoff
Gadsden, AL 35903
Phone (205) 492-0131

1201 Notasulga Rd
Tuskegee, AL 36083
Phone (334) 727-7211

1500 E Shotwell St
Bainbridge, GA 39819
Phone (229) 243-6100

102 Hospital Cir
Donalsonville, GA 39845

915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575

Interoperability endpoints

  • Direct secure messaging: vlewisholland333160@direct.ochin.org

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487721718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E SHOTWELL ST",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194256",
            "telephone_number": "229-246-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E SHOTWELL ST",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194256",
            "telephone_number": "229-246-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS-HOLLAND",
        "first_name": "VICTORIA",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "GA",
            "license": "041156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000582909N",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge, GA

Sources for this page

Verify at the official NPI Registry.