Individual provider Active NPI

Don B Holton, M.D.

  • Diagnostic Radiology Physician
  • Shreveport, LA
National Provider Identifier
1811030174
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
009971 Issued in LA
Practice address
7330 Fern Ave
Suite 402
Shreveport, LA 71105-4971
Phone
(318) 221-2535
Fax
(318) 227-8636
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 009971 LA Primary

Addresses

Primary practice location

7330 Fern Ave
Suite 402
Shreveport, LA 71105-4971

Mailing address

PO Box 2267
Shreveport, LA 71166-2267
Phone (318) 221-2535

Other identifiers 1

IdentifierTypeStateIssuer
1181200MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20041004000758 LA Practitioner - Diagnostic Radiology 6406815760 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009971LAMDDiagnostic Radiology Physician
9971LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children CurrentSince May 7, 2021 Accepting new patients
Shriners Hospitals for Children CurrentSince May 7, 2021 Accepting new patients
Shriners Hospitals for Children Current Accepting new patients
Minden Anesthesiology Associates, LLC Past Accepting new patients
Home Physicians Services, LLC Past Accepting new patients

Locations

3100 Samford Ave
Shreveport, LA 71103
Phone (318) 222-5704

Organizations & group practices 6

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811030174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2267",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711662267",
            "telephone_number": "318-221-2535",
            "fax_number": "318-227-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7330 FERN AVE",
            "address_2": "SUITE 402",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054971",
            "telephone_number": "318-221-2535",
            "fax_number": "318-227-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTON",
        "first_name": "DON",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "009971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1181200",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.