Individual provider Active NPI

Edward S Holt, MD

  • Orthopaedic Foot and Ankle Surgery Physician
  • Annapolis, MD
National Provider Identifier
1669475216
Registry record updated Jul 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X
License
D30372 Issued in MD
Practice address
2000 Medical Pkwy
Suite 101
Annapolis, MD 21401-3742
Phone
(410) 268-8862
Fax
(410) 280-4701
NPI assigned
May 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X D30372 MD Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X D30372 MD

Addresses

Primary practice location

2000 Medical Pkwy
Suite 101
Annapolis, MD 21401-3742

Mailing address

201 Defense Hwy
Ste 100
Annapolis, MD 21401-8902
Phone (667) 204-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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
I20040129000324 DC Practitioner - Orthopedic Surgery 1052214806
I20090612000010 MD Practitioner - Orthopedic Surgery 1052214806 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC CurrentSince May 1, 2009 Accepting new patients

Locations

2000 Medical Pkwy
Ste 101
Annapolis, MD 21401
Phone (410) 295-8900

4175 N Hanson Ct
Ste 301
Bowie, MD 20716
Phone (301) 805-0190

15500 Annapolis Rd
Ste 102
Bowie, MD 20715
Phone (301) 805-0190

8638 Veterans Hwy
Millersville, MD 21108
Phone (410) 729-4508

Interoperability endpoints

  • Direct secure messaging: eholt4624@direct.aahs.org

Organizations & group practices 1

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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1669475216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 DEFENSE HWY",
            "address_2": "STE 100",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214018902",
            "telephone_number": "667-204-7000",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MEDICAL PKWY",
            "address_2": "SUITE 101",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013742",
            "telephone_number": "410-268-8862",
            "fax_number": "410-280-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "EDWARD",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "MD",
            "license": "D30372",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MD",
            "license": "D30372",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.