Individual provider Active NPI

Laura Holton, DO

  • Student in an Organized Health Care Education/Training Program
  • Philadelphia, PA
National Provider Identifier
1760234355
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
4190 City Ave
Philadelphia, PA 19131-1626
Phone
(215) 871-6730
NPI assigned
Apr 4, 2024
Last updated
May 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

4190 City Ave
Philadelphia, PA 19131-1626

Mailing address

59 Corso Italia Unit a
Freehold, NJ 07728-9467
Phone (732) 609-6382

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250728002551 PA Order and Referring Only - General SurgeryPractitioner - General Surgery 0941717615

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1712188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1760234355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 CORSO ITALIA UNIT A",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077289467",
            "telephone_number": "732-609-6382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 CITY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311626",
            "telephone_number": "215-871-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTON",
        "first_name": "LAURA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-04",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.