Active NPI
Holt Family Practice PC
- Family Medicine Physician
- Holt, MI
National Provider Identifier
1790898070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- HOLT FAMILY PRACTICE PC
- Practice address
- 4378 Holt Rd
Holt, MI 48842-1666 - Phone
- (517) 694-1466
- Fax
- (517) 694-5142
- NPI assigned
- Aug 17, 2006
- Last updated
- Mar 26, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Mark M Richardson, M.D.
- Title
- President
- Phone
- (517) 694-1466
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
4378 Holt Rd
Holt, MI 48842-1666
Mailing address
4378 Holt Rd
Holt, MI 48842-1666
Phone (517) 694-1466
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 080C364770 | Other | MI | BCBS GROUP ID |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
4378 Holt Rd
Holt, MI 48842
Phone (517) 694-1466
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1206489600000",
"number": "1790898070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4378 HOLT RD",
"city": "HOLT",
"state": "MI",
"postal_code": "488421666",
"telephone_number": "517-694-1466",
"fax_number": "517-694-5142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4378 HOLT RD",
"city": "HOLT",
"state": "MI",
"postal_code": "488421666",
"telephone_number": "517-694-1466",
"fax_number": "517-694-5142"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOLT FAMILY PRACTICE PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-17",
"last_updated": "2008-03-26",
"status": "A",
"authorized_official_last_name": "RICHARDSON",
"authorized_official_first_name": "MARK",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "517-694-1466",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS GROUP ID",
"identifier": "080C364770",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Holt, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.