Individual provider Active NPI

George Thomas Holland, MD

  • Family Medicine Physician
  • Southport, NC
National Provider Identifier
1679550305
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
39512 Issued in NC
Practice address
924 N Howe St
Southport, NC 28461-3038
Phone
(910) 457-3800
Fax
(910) 457-7066
NPI assigned
Dec 22, 2005
Last updated
Jun 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 39512 NC Primary

Addresses

Primary practice location

924 N Howe St
Southport, NC 28461-3038

Mailing address

PO Box 96860
Charlotte, NC 28296-6860
Phone (910) 754-2273

Other practice location 1

4503 Main St Ste 1
Shallotte, NC 28470-4583
Phone (910) 754-2273

Other identifiers 8

IdentifierTypeStateIssuer
0128732OtherNCUNITED HEALTHCARE
20904OtherNCCIGNA
0054OtherNCAETNA
92258OtherNCMEDCOST
43093OtherNCBCBSNC
8943093MedicaidNC
9663589OtherNCGHI
080149894OtherNCRAILROAD ,MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20051115000839 NC Practitioner - Family Practice 8729007141 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39512NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
J. Arthur Dosher Memorial Hospital Current Accepting new patients
RDMG Associates PA Family Medicine CurrentSince Jan 1, 2017 Accepting new patients
RDMG Associates, PA CurrentSince Jan 1, 2017 Accepting new patients
RDMG Associates PA Family Medicine Past Accepting new patients

Locations

10620 Park Rd
Ste 128
Charlotte, NC 28210
Phone (704) 542-6111

4503 Main St
Ste 1
Shallotte, NC 28470
Phone (910) 754-2273

821 N Atlantic Ave
Southport, NC 28461
Phone (910) 457-3827

905 N Howe St
Southport, NC 28461
Phone (910) 457-3827

924 N Howe St
Southport, NC 28461
Phone (910) 457-3800

924 N Howe St
#A
Southport, NC 28461
Phone (910) 454-1166

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1679550305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96860",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282966860",
            "telephone_number": "910-754-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 N HOWE ST",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284613038",
            "telephone_number": "910-457-3800",
            "fax_number": "910-457-7066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4503 Main St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Shallotte",
            "state": "NC",
            "postal_code": "284704583",
            "country_code": "US",
            "telephone_number": "910-754-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "GEORGE",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "39512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0128732",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "20904",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0054",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "92258",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "43093",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8943093",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "9663589",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD ,MEDICARE",
            "identifier": "080149894",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, NC

Sources for this page

Verify at the official NPI Registry.