Jacob Peter Holton, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036.152725 Issued in IL

Practice address

2200 E Washington St
Bloomington, IL 61701-4364

Phone

(309) 662-3311

NPI assigned

Jun 8, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment NPD
• Saint Francis Medical Center

  • Physical Medicine & Rehabilitation Physician
  • Peoria, IL
  • NPI 1023062312
  Medicare reassignment NPD
• Saint James Hospital

  • Anesthesiology Physician
  • Pontiac, IL
  • NPI 1790735421
  Medicare reassignment NPD
• St Joseph Medical Center

  • Family Medicine Physician
  • Bloomington, IL
  • NPI 1871547414
  Medicare reassignment NPD
• St Mary Medical Center

  • Emergency Medical Services (Emergency Medicine) Physician
  • Galesburg, IL
  • NPI 1962467670
  Medicare reassignment NPD
• Bloomington Medical Laboratory Physicians, S.C.

  • Anatomic Pathology & Clinical Pathology Physician
  • Bloomington, IL
  • NPI 1841229507
  NPD
• Saint Francis Medical Center

  • Home Health Agency
  • Peoria, IL
  • NPI 1346281425
  NPD
• Saint Francis Medical Center

  • Emergency Medical Services (Emergency Medicine) Physician
  • Peoria, IL
  • NPI 1952351397
  NPD
• Saint James Hospital

  • Rural Health Clinic/Center
  • Roanoke, IL
  • NPI 1164138848
  NPD
• St Joseph Medical Center

  • General Acute Care Hospital
  • Bloomington, IL
  • NPI 1619916806
  NPD
• St Joseph Medical Center

  • Emergency Medicine Physician
  • Bloomington, IL
  • NPI 1659552859
  NPD
• St Mary Medical Center

  • Rural Health Clinic/Center
  • Galesburg, IL
  • NPI 1275234965
  NPD

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1821527201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 E WASHINGTON ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617014364",
            "telephone_number": "309-662-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 E WASHINGTON ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617014364",
            "telephone_number": "309-662-3311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1750 W Harrison St Ste 108",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123825",
            "country_code": "US",
            "telephone_number": "312-942-7802",
            "fax_number": "312-942-4021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLTON",
        "first_name": "JACOB",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-07-21",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125070487",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.152725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert L Hollis
• Khaila A Holman
• Janellen Appel Holmes, LCPC
• Justin James Holschbach, M.D.
• Paige C. Holt, MD
• Lindsey Holzhauer, LCSW
• Home Dialysis Services Bloomington LLC
• Home Health Depot
• Home Health Depot Inc
• Narumon Hongrattanavorakit

• Emergency Medicine Physician in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.