Douglas S Holt, CST

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

237000196 Issued in IL

Practice address

1604 Visa Dr Ste 1
Normal, IL 61761-2195

Phone

(309) 846-4716

Fax

(309) 454-7348

NPI assigned

Aug 9, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1565308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1538714191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 VISA DR STE 1",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617612195",
            "telephone_number": "309-846-4716",
            "fax_number": "309-454-7348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 VISA DR STE 1",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617612195",
            "telephone_number": "309-846-4716",
            "fax_number": "309-454-7348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 W Park St",
            "address_purpose": "LOCATION",
            "city": "Urbana",
            "state": "IL",
            "postal_code": "618012334",
            "country_code": "US",
            "telephone_number": "217-337-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1304 Franklin Ave",
            "address_purpose": "LOCATION",
            "city": "Normal",
            "state": "IL",
            "postal_code": "617613558",
            "country_code": "US",
            "telephone_number": "309-454-1400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLT",
        "first_name": "DOUGLAS",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "CST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-09",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "IL",
            "license": "237000196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jolie M. Hoffmann, PSY.D
• Hannah Rose Hogue
• Linda Hokanson, L.C.S.W.
• Tammi Holmes, CST
• Claire Elizabeth Holt
• Shelby Holt, RDN
• Travis Holt, M.D.
• Jennifer Homan
• Home Town Optical LLC
• Homes of Hope, Inc.

• Surgical Assistant in Normal, IL
• Providers in Normal, IL by specialty
• Surgical Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.