NPI Code Detail JSON Logo

1538833983 NPI number — MADISON TAYLOR HOLTZ PA-C

NPI Number: 1538833983
Health Care Provider/Practitioner: MADISON TAYLOR HOLTZ PA-C

Information about “1538833983” NPI (MADISON TAYLOR HOLTZ PA-C) exists in 1538833983 in HTML format HTML  |  1538833983 in plain Text format TXT  |  1538833983 in PDF (Portable Document Format) PDF  |  1538833983 in an XML format XML  formats.

NPI Number : 1538833983 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1538833983",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HOLTZ",
    "FirstName": "MADISON",
    "MiddleName": "TAYLOR",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "PA-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2807 WINDING LN NE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BROOKHAVEN",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30319-3235",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "678-588-4056",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1110 W PEACHTREE ST NW STE 1100",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ATLANTA",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30309-3609",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "404-892-2131",
    "PracticeLocationAddressFaxNumber": "404-215-9222",
    "EnumerationDate": "08/08/2021",
    "LastUpdateDate": "02/08/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363AM0700X",
        "TaxonomyName": "Medical Physician Assistant",
        "LicenseNumber": "10469",
        "LicenseNumberStateCode": "GA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.