Individual provider Active NPI

Cheryl Lavern Holder, M.D.

  • Internal Medicine Physician
  • Cutler Bay, FL
National Provider Identifier
1780626820
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME51226 Issued in FL
Practice address
10300 SW 216TH St
Cutler Bay, FL 33190-1003
Phone
(305) 253-5100
NPI assigned
Jun 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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 ME51226 FL Primary

Addresses

Primary practice location

10300 SW 216TH St
Cutler Bay, FL 33190-1003

Mailing address

10300 SW 216TH St
Cutler Bay, FL 33190-1003
Phone (305) 253-5100

Other identifiers 2

IdentifierTypeStateIssuer
048141600MedicaidFL
120731000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20051012000341 FL Practitioner - Internal Medicine 4385669001 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health of South Florida, Inc CurrentSince Dec 24, 2023 Accepting new patients
Community Health of South Florida, Inc. CurrentSince Dec 24, 2023 Accepting new patients
Community Health of South Florida Inc Current Accepting new patients
Public Health Trust of Miami Dade County Florida Past Accepting new patients
Public Health Trust of Miami Dade County Florida Past Accepting new patients

Locations

10300 SW 216th St
Cutler Bay, FL 33190

13600 SW 312th St
Homestead, FL 33033
Phone (305) 242-2000

Interoperability endpoints

  • Direct secure messaging: cheryl.holder.1@27920.direct.athenahealth.com

Organizations & group practices 5

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1780626820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300 SW 216TH ST",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331901003",
            "telephone_number": "305-253-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 SW 216TH ST",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331901003",
            "telephone_number": "305-253-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDER",
        "first_name": "CHERYL",
        "middle_name": "LAVERN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME51226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048141600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120731000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cutler Bay, FL

Sources for this page

Verify at the official NPI Registry.