Individual provider Active NPI

Mark Alan Holowka, CPO

  • Orthotist
  • Atlanta, GA
National Provider Identifier
1619687597
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OrthotistTaxonomy code 222Z00000X
License
110 Issued in GA
Practice address
5445 Meridian Mark Rd Ste 200
Atlanta, GA 30342-4755
Phone
(404) 785-3229
Fax
(404) 785-5690
NPI assigned
Dec 1, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetist 224P00000X 110 GA
Orthotist 222Z00000X 110 GA Primary

Addresses

Primary practice location

5445 Meridian Mark Rd Ste 200
Atlanta, GA 30342-4755

Mailing address

470 Elgaen CT
Roswell, GA 30075-2588
Phone (404) 279-0764

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
110GAMDProsthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Scottish Rite Childrens Medical Ctr PastSince Dec 6, 2022 Accepting new patients
Children'S Healthcare of Atlanta at Scottish Rite PastSince Dec 6, 2022 Accepting new patients

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": "1669852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1619687597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 ELGAEN CT",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300752588",
            "telephone_number": "404-279-0764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 MERIDIAN MARK RD STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424755",
            "telephone_number": "404-785-3229",
            "fax_number": "404-785-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLOWKA",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "credential": "CPO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-01",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "GA",
            "license": "110",
            "primary": false
        },
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "GA",
            "license": "110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.