KIRK S HOLSTON DPM NPI 1760462089

NPI Information

NPI: 1760462089
Provider Name: KIRK S HOLSTON, DPM
Classification: Podiatrist - 213ES0103X
Entity Type: Individual

Specialization: Foot & Ankle Surgery

PECOS Registration: Yes

Address:
3850 SHORE DR
SUITE 301
INDIANAPOLIS, IN
ZIP 46254
Phone: (317) 297-3338
Get Directions

Kirk S Holston, DPM is a foot and ankle surgery podiatrist in Indianapolis, IN with 44 years of experience. Kirk S Holston, DPM NPI is 1760462089. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: WILLIAM M. SCHOLL COLLEGE OF PODIATRIC MEDICINE
Graduation Year:1980

The provider's business location address is:

3850 SHORE DR
SUITE 301
INDIANAPOLIS, IN
ZIP 46254-621
Phone: (317) 297-3338
Fax: (317) 297-9997

The NPI 1760462089 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 1/20/2006 and was last updated on 11/23/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208100000X	Physical Medicine & Rehabilitation		05001328A	INDIANA	No
2	213E00000X	Podiatrist		070000768A	INDIANA	No
3	213ES0103X	Podiatrist	Foot & Ankle Surgery	070000768A	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100121880	MEDICAID	INDIANA
2	202158547	OTHER	INDIANA	TRICARE
3	0005497063	OTHER	INDIANA	AETNA
4	P00284245	OTHER		RR MCR
5	100121880A	MEDICAID	INDIANA
6	000000364510	OTHER	INDIANA	ANTHEM BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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