Active NPI
Craig D Holman Chartered
- Podiatrist
- Twin Falls, ID
National Provider Identifier
1609085455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- P119
- Legal business name
- CRAIG D HOLMAN CHARTERED
- Practice address
- 496 Shoup Ave W # B
Twin Falls, ID 83301-5043 - Phone
- (208) 734-7676
- Fax
- (208) 736-8378
- NPI assigned
- May 21, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Craig D Holman, DPM
- Title
- Owner
- Phone
- (208) 734-7676
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | P119 | ID | Primary |
Addresses
Primary practice location
496 Shoup Ave W # B
Twin Falls, ID 83301-5043
Mailing address
496 Shoup Ave W # B
Twin Falls, ID 83301-5043
Phone (208) 734-7676
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 185440600 | Other | ID | US DEPT OF LABOR |
| 4134570001 | Other | ID | DMERC |
| 480031477 | Other | ID | RAILROAD MEDICARE |
| 000010152611 | Other | ID | REGENCE BLUE SHIELD OF ID |
| P9343 | Other | ID | BLUE CROSS OF IDAHO |
Other names 1
- Magic Valley Foot & Ankle Specialist
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1529539200000",
"number": "1609085455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "496 SHOUP AVE W # B",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833015043",
"telephone_number": "208-734-7676",
"fax_number": "208-736-8378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "496 SHOUP AVE W # B",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833015043",
"telephone_number": "208-734-7676",
"fax_number": "208-736-8378"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CRAIG D HOLMAN CHARTERED",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-21",
"last_updated": "2018-06-21",
"status": "A",
"authorized_official_last_name": "HOLMAN",
"authorized_official_first_name": "CRAIG",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "208-734-7676",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist",
"state": "ID",
"license": "P119",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US DEPT OF LABOR",
"identifier": "185440600",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMERC",
"identifier": "4134570001",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "480031477",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD OF ID",
"identifier": "000010152611",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF IDAHO",
"identifier": "P9343",
"state": "ID"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Magic Valley Foot & Ankle Specialist",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.