Staci M Holles-Sobota, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

37739 Issued in SC

Practice address

8384 Charlotte Hwy
Indian Land, SC 29707-6532

Phone

(703) 689-9037

Fax

(703) 689-9109

NPI assigned

Aug 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Emergency Physician Services

  • Radiology Clinic/Center
  • Greenville, SC
  • NPI 1720471618
  NPD (past)
• Emergency Medicine Associates P.a., P.C.

  • Emergency Medicine Physician
  • Falls Church, VA
  • NPI 1134117393
  NPD (past)
• Mid-Atlantic Critical Care Services,L.L.C.

  • Critical Care Medicine (Internal Medicine) Physician
  • Takoma Park, MD
  • NPI 1164455853
  NPD (past)

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1740471077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 PICCARD DRIVE",
            "address_2": "SUITE 202 EMERGENCY MEDICINE ASSOCIATES",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504303",
            "telephone_number": "301-921-7900",
            "fax_number": "301-921-7915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8384 CHARLOTTE HWY",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297076532",
            "telephone_number": "703-689-9037",
            "fax_number": "703-689-9109"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "502 Sixth Baxter Xing",
            "address_purpose": "LOCATION",
            "city": "Fort Mill",
            "state": "SC",
            "postal_code": "297086596",
            "country_code": "US",
            "telephone_number": "803-396-8100",
            "fax_number": "803-396-8040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1190 Filbert Hwy Ste 110",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "SC",
            "postal_code": "297459324",
            "country_code": "US",
            "telephone_number": "803-628-0004",
            "fax_number": "803-628-6004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLES-SOBOTA",
        "first_name": "STACI",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "37739",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0102202037",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "37739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377391",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hearusa, Inc.
• Patricia Heitz, HEALTH & WELLNESS CO
• Darlene Hildebrandt, PHARMD
• Jennifer Hix
• Jessie Baldwin Hoffman, PHD, RD
• Kayce Marie Hoover, NP-C
• Christina Huber, DDS
• Tiffany Clarissa Huggins, MED,NCC,LPCS,LCMHCS
• Samia Hunter
• Ideal Dental Indian Land PC

• Family Medicine Physician in Indian Land, SC
• Providers in Indian Land, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; 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.