Individual provider Active NPI

Thomas R. Holda, M.D.

  • Internal Medicine Physician
  • Saint Joseph, MO
National Provider Identifier
1740358282
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301047980 Issued in MI
Practice address
5514 Corporate Dr Ste 120
Saint Joseph, MO 64507-7754
Phone
(816) 271-7169
Fax
(816) 271-8810
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301047980 MI Primary

Addresses

Primary practice location

5514 Corporate Dr Ste 120
Saint Joseph, MO 64507-7754

Mailing address

5514 Corporate Dr Ste 120
Saint Joseph, MO 64507-7754
Phone (816) 271-1350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, WY2 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
I20220831002180 RI Practitioner - Internal Medicine 9335137124 Reassigns benefits to 1 organization
I20240521003447 WY Practitioner - Internal Medicine 9335137124 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell County Hospital District Current Accepting new patients
Campbell County Hospital District Internal Medicine Current Accepting new patients
Campbell County Hospital District CurrentSince Jun 3, 2024 Accepting new patients
Campbell County Hospital District, CurrentSince Jun 3, 2024 Accepting new patients
Midwestern Health Management, Inc. Past Accepting new patients

Locations

501 S Burma Ave
Fl 3
Gillette, WY 82716
Phone (307) 688-3636

501 S Burma Ave
Gillette, WY 82716
Phone (307) 682-8811

Organizations & group practices 6

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1740358282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5514 CORPORATE DR STE 120",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645077754",
            "telephone_number": "816-271-1350",
            "fax_number": "816-271-1355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5514 CORPORATE DR STE 120",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645077754",
            "telephone_number": "816-271-7169",
            "fax_number": "816-271-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDA",
        "first_name": "THOMAS",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301047980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

Verify at the official NPI Registry.