Individual provider Active NPI

John R Holland, D.O.

  • Emergency Medicine Physician
  • Lincoln City, OR
National Provider Identifier
1679675854
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO172963 Issued in OR
Practice address
3043 NE 28TH Street
Lincoln City, OR 97367-9540
Phone
(541) 996-7118
Fax
(541) 996-7378
NPI assigned
Sep 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 1948 TN
Emergency Medicine Physician 207P00000X 200400681 NC
Emergency Medicine Physician 207P00000X DO172963 OR Primary

Addresses

Primary practice location

3043 NE 28TH Street
Lincoln City, OR 97367-9540

Mailing address

3043 NE 28TH Street
Lincoln City, OR 97367-9540

Other identifiers 2

IdentifierTypeStateIssuer
891362YMedicaidNC
1679675854MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TN, VA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20040729000313 NC Practitioner - Emergency MedicinePractitioner - Internal Medicine 4587559208 Reassigns benefits to 3 organizations
I20090616000822 TN Practitioner - Emergency Medicine 4587559208 Reassigns benefits to 1 organization
I20200409003149 VA Practitioner - Emergency Medicine 4587559208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Virginia Regional Emergency Physicians LLCGroup PAC ID 4183991227, 88 clinicians
Tri-Cities Regional Emergency Physicians, PCGroup PAC ID 3678859477, 118 clinicians
The Carolinas Emergency Group, PLLCGroup PAC ID 2567486814, 62 clinicians

Practice addresses (Care Compare)

100 15TH St NW
Norton, VA 24273-1616
Phone (276) 439-1000

1901 S Shady St
Mountain City, TN 37683-2021
Phone (423) 727-1100

2301 US Hwy 74 W
Wadesboro, NC 28170-7554
Phone (704) 694-5131

Hospital & facility affiliations

  • Johnson County Community Hospital Hospital, Mountain City, TN, CCN 441304
  • Lonesome Pine Hospital Hospital, Big Stone Gap, VA, CCN 490114

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1948TNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Cities Regional Emergency Physicians, PC Emergency Medicine CurrentSince Jan 8, 2023 Accepting new patients
The Carolinas Emergency Group, PLLC Emergency Medicine CurrentSince Jun 1, 2018 Accepting new patients
Jefferson Emergency Services, PLLC Emergency Medicine CurrentSince Jan 1, 2020 Accepting new patients
Yadkin Emergency Physicians, PLLC Emergency Medicine CurrentSince Dec 28, 2022 Accepting new patients
Johnson City Emergency Physicians, PC Emergency Medicine Past Accepting new patients
North Carolina Emergency Physicians, PLLC Emergency Medicine PastSince Feb 9, 2020 Accepting new patients
Hospital Health Care Inc. Past Accepting new patients
Lumberton Emergency Medical Associates PC Emergency Medicine PastSince Oct 1, 2023 Accepting new patients

Locations

200 Corporate Blvd
Lafayette, LA 70508

180 Parkwood Dr
Elkin, NC 28621
Phone (336) 527-7000

200 Hospital Ave
Jefferson, NC 28640
Phone (336) 246-7101

600 Hospital Dr
Monroe, NC 28112
Phone (704) 283-3100

2201 S Sterling St
Morganton, NC 28655
Phone (828) 580-6393

2301 US Highway 74 W
Wadesboro, NC 28170
Phone (704) 694-5131

1501 W Elk Ave
Elizabethton, TN 37643
Phone (423) 542-1300

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

1901 S Shady St
Mountain City, TN 37683
Phone (423) 727-1100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 9

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1679675854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3043 NE 28TH STREET",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973679540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3043 NE 28TH STREET",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973679540",
            "telephone_number": "541-996-7118",
            "fax_number": "541-996-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "1948",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "200400681",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "DO172963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891362Y",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679675854",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln City, OR

Sources for this page

Verify at the official NPI Registry.