Provider Type Icon

JACOB ERIC RONALD HOLT MD NPI 1194831636


NPI Information

NPI: 1194831636
Provider Name: JACOB ERIC RONALD HOLT, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
119 BOONE RIDGE DR
SUITE 201
JOHNSON CITY, TN
ZIP 37615
Phone: (423) 282-1480
Get Directions

Jacob Eric Ronald Holt, MD is a family medicine in Johnson City, TN with 23 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Jacob Eric Ronald Holt, MD NPI is 1194831636. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: EAST TENNESSEE STATE UNIVERSITY QUILLEN COLLEGE OF MEDICINE
Graduation Year:2001

The provider's business location address is:

119 BOONE RIDGE DR
SUITE 201
JOHNSON CITY, TN
ZIP 37615-998
Phone: (423) 282-1480
Fax: (423) 928-1353

The NPI 1194831636 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), Power Mobility Devices.

The enumeration date for this NPI number is 8/21/2006 and was last updated on 5/8/2014.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208M00000XHospitalist42090TENNESSEENo
2207R00000XInternal Medicine42866COLORADONo
3207Q00000XFamily Medicine42090TENNESSEEYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1I17871MEDICARE UPIN
273375039MEDICAIDCOLORADO
33000017MEDICAIDTENNESSEE
4900010MEDICARE ID-TYPE UNSPECIFIED
53000017MEDICARE PINTENNESSEE

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.