Walter G Holloman Jr., MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

R6596 Issued in MO

Practice address

3015 N New Ballas Rd
St Louis, MO 63131

Phone

(314) 996-5180

Fax

(314) 821-2180

NPI assigned

Oct 23, 2006

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

Other identifiers 18

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Midwest Radiological Associates PC

  • Diagnostic Radiology Physician
  • St Louis, MO
  • NPI 1821013418
  NPD (past)

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237334400000",
    "number": "1942383914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WESTPORT PLZ",
            "address_2": "SUITE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463109",
            "telephone_number": "314-548-4772",
            "fax_number": "314-548-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 N NEW BALLAS RD",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63131",
            "telephone_number": "314-996-5180",
            "fax_number": "314-821-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOMAN",
        "first_name": "WALTER",
        "middle_name": "G",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2009-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "R6596",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036061640",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "H LINK",
            "identifier": "135370",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATE WAY",
            "identifier": "A12402",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE",
            "identifier": "002013128",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PH PLAN",
            "identifier": "1600226",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE USA",
            "identifier": "6167",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "2781",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "27600",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR CARE",
            "identifier": "300066998",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO CARE",
            "identifier": "017012444",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL CAID",
            "identifier": "04802710571",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO CAID",
            "identifier": "201047818",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC MCAID",
            "identifier": "201047818",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY",
            "identifier": "431725842MID",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO CARE",
            "identifier": "002013128",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE",
            "identifier": "017012444",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HLT PART",
            "identifier": "398023",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL BLUE",
            "identifier": "0090000352",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO BLUE",
            "identifier": "1390",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jane M Hollman, ANP
• Cynthia Hollmann
• Killian Mark Hollo
• Richard Joseph Hollocher, M.D.
• Jameson Holloman, MD
• Mary Brigid Holloran-Schwartz, M.D.
• Angela Christine Holloway, MPT
• Erin Holloway, ANP
• Lauren A Holloway, CPNP
• William Edward Holloway, MD

• Diagnostic Radiology Physician in St Louis, MO
• Providers in St Louis, MO by specialty
• Diagnostic Radiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2009; 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.