Individual provider Active NPI

Dennis Wendell Holder Jr., M.D.

  • Emergency Medicine Physician
  • Macon, GA
National Provider Identifier
1992731210
Registry record updated Mar 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
055758 Issued in GA
Practice address
777 Hemlock St
Hospital Box 142
Macon, GA 31201-2102
Phone
(478) 633-7707
Fax
(478) 633-7879
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 055758 GA Primary

Addresses

Primary practice location

777 Hemlock St
Hospital Box 142
Macon, GA 31201-2102

Mailing address

777 Hemlock St
MSC 142
Macon, GA 31201-2102
Phone (478) 633-7707

Other identifiers 1

IdentifierTypeStateIssuer
735500172AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20050804000524 GA Practitioner - Emergency Medicine 6507852209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Mercer University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Georgia Emergency Group LLCGroup PAC ID 5991004608, 27 clinicians

Practice addresses (Care Compare)

777 Hemlock St
Macon, GA 31201-2102
Phone (478) 633-1000

Hospital & facility affiliations

  • Atrium Health Navicent the Medical Center Hospital, Macon, GA, CCN 110107

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
99.18
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Georgia Emergency Group, LLC Emergency Medicine CurrentSince May 1, 2016 Accepting new patients

Locations

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

777 Hemlock St
#142
Macon, GA 31201
Phone (478) 633-7707

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427068800000",
    "number": "1992731210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST",
            "address_2": "MSC 142",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012102",
            "telephone_number": "478-633-7707",
            "fax_number": "478-633-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST",
            "address_2": "HOSPITAL BOX 142",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012102",
            "telephone_number": "478-633-7707",
            "fax_number": "478-633-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDER",
        "first_name": "DENNIS",
        "middle_name": "WENDELL",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2015-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "055758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "735500172A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.