Organization Active NPI

Holt Family Practice PC

  • Family Medicine Physician
  • Holt, MI
National Provider Identifier
1790898070
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
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, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
080C364770OtherMIBCBS GROUP ID

National Provider Directory

National Provider Directory

Member 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.

Verify at the official NPI Registry.