Individual provider Active NPI

Steven Allen Holman, AGNP

  • Gerontology Nurse Practitioner
  • Caro, MI
National Provider Identifier
1851718399
Registry record updated Apr 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
4704266143 Issued in MI
Practice address
1525 W Caro Rd
Caro, MI 48723-9686
Phone
(989) 672-2100
NPI assigned
Mar 22, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 4704266143 MI
Student in an Organized Health Care Education/Training Program 390200000X
Gerontology Nurse Practitioner 363LG0600X 4704266143 MI Primary

Addresses

Primary practice location

1525 W Caro Rd
Caro, MI 48723-9686

Mailing address

9904 Alba Hwy
Elmira, MI 49730-9299
Phone (231) 584-2091

Other practice location 1

9904 Alba Hwy
Elmira, MI 49730-9299
Phone (231) 584-2091

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151201000656 MI Practitioner - Nurse Practitioner 0345540134 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shattuck Family Physicians PLLCGroup PAC ID 4486949807, 16 clinicians

Practice addresses (Care Compare)

1525 W Caro Rd
Shattuck Family Physicians
Caro, MI 48723-9686
Phone (989) 860-0088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704266143MIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shattuck Family Physicians PLLC CurrentSince Mar 1, 2019 Accepting new patients
Caro Health Plaza PLC CurrentSince Jul 1, 2018 Accepting new patients
Mid Michigan Medicine PC CurrentSince Dec 1, 2015 Accepting new patients
Saginaw Valley Walk in Clinic, PLLC CurrentSince Jun 18, 2018 Accepting new patients
Caro Health Plaza PLC CurrentSince Jul 1, 2018 Accepting new patients
Mohamed Ally Health Plaza PLLC CurrentSince May 1, 2019 Accepting new patients
Pinnacle Health Care PLC CurrentSince Apr 1, 2017 Accepting new patients
Columbiaville Family Clinic PLLC CurrentSince Aug 26, 2018 Accepting new patients

Locations

1070 E Caro Rd
Caro, MI 48723
Phone (989) 672-0341

1525 W Caro Rd
Caro, MI 48723
Phone (989) 672-2100

1525 W Caro Rd
Ste A
Caro, MI 48723
Phone (989) 860-0088

2425 Austins Pkwy
Ste 1
Flint, MI 48507
Phone (810) 238-8889

387 N State Rd
Ste B
Otisville, MI 48463
Phone (810) 631-0355

387 N State Rd
Ste A
Otisville, MI 48463
Phone (810) 631-4060

3020 Boardwalk Dr
Saginaw, MI 48603
Phone (989) 791-3852

2575 McLeod Dr N
Ste A
Saginaw, MI 48604
Phone (810) 631-4060

2575 McLeod Dr N
Saginaw, MI 48604
Phone (989) 797-5532

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15478/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/20296/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/15223/brand/1/csg/1/fhir/r4

Organizations & group practices 9

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": "1395446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1851718399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9904 ALBA HWY",
            "city": "ELMIRA",
            "state": "MI",
            "postal_code": "497309299",
            "telephone_number": "231-584-2091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 W CARO RD",
            "city": "CARO",
            "state": "MI",
            "postal_code": "487239686",
            "telephone_number": "989-672-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9904 Alba Hwy",
            "address_purpose": "LOCATION",
            "city": "Elmira",
            "state": "MI",
            "postal_code": "497309299",
            "country_code": "US",
            "telephone_number": "231-584-2091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLMAN",
        "first_name": "STEVEN",
        "middle_name": "ALLEN",
        "credential": "AGNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-22",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704266143",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704266143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caro, MI

Sources for this page

Verify at the official NPI Registry.