Individual provider Active NPI

David Charles Holman, DPM

  • Podiatrist
  • Mifflinburg, PA
National Provider Identifier
1750378808
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC002738L Issued in PA
Practice address
101 E Chestnut St
Mifflinburg, PA 17844-9607
Phone
(570) 966-3155
Fax
(570) 966-6901
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC002738L PA Primary

Addresses

Primary practice location

101 E Chestnut St
Mifflinburg, PA 17844-9607

Mailing address

101 E Chestnut St
Mifflinburg, PA 17844-9607
Phone (570) 966-3155

Other identifiers 2

IdentifierTypeStateIssuer
0010047840001MedicaidPA
01522701OtherPACAPITAL BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100831000228 PA Practitioner - Podiatry 8123142973 Practice locations: Mifflinburg, PA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

101 E Chestnut St
Mifflinburg, PA 17844-9607
Phone (570) 966-3155

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue119
Removal of nail tissue1273
Removal or shaving of skin growth146

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC002738LPAMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1750378808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E CHESTNUT ST",
            "city": "MIFFLINBURG",
            "state": "PA",
            "postal_code": "178449607",
            "telephone_number": "570-966-3155",
            "fax_number": "570-966-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E CHESTNUT ST",
            "city": "MIFFLINBURG",
            "state": "PA",
            "postal_code": "178449607",
            "telephone_number": "570-966-3155",
            "fax_number": "570-966-6901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMAN",
        "first_name": "DAVID",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC002738L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010047840001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BCBS",
            "identifier": "01522701",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mifflinburg, PA

Sources for this page

Verify at the official NPI Registry.