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Export Provider Record NPI 1053623330
Justin James HolschbachM.D.
Active
NPI Number1053623330
NPI TypeNPI-1 Individual
SpecialtyFamily Medicine
Provider Details
NPI1053623330
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2010-07-02
Last Updated2013-08-08
Mailing Address308 Saint Joseph Dr
Bloomington, IL 61701-3506
United States
Phone: (309) 663-5050 | Fax: (309) 662-3401
📍 View Map
Primary Practice Address308 Saint Joseph Dr
Bloomington, IL 61701-3506
United States
Phone: (309) 663-5050 | Fax: (309) 662-3401
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes207Q00000X – Family MedicineIL036.132875
No207Q00000X – Family MedicineMO2012030856
Export Provider Record NPI 1053623330
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About NPI 1053623330

Justin James Holschbach M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1053623330. The primary specialty listed is Family Medicine. The provider is located in Bloomington, IL. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2010-07-02. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1053623330?

NPI 1053623330 belongs to Justin James Holschbach M.D., a Family Medicine in Bloomington, IL. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1053623330 active?

The current status of NPI 1053623330 in the NPPES registry is Active. The record was last updated on 2013-08-08.

What specialty is NPI 1053623330?

NPI 1053623330 is classified under the taxonomy Family Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1053623330?

You can verify NPI 1053623330 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1053623330?

The primary practice address on file for NPI 1053623330 is 308 Saint Joseph Dr, Bloomington, IL 61701-3506. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1053623330 issued?

NPI 1053623330 was first issued (enumerated) on 2010-07-02. The NPPES record was last updated on 2013-08-08.

Practice Location Map

Justin James Holschbach is located at 308 Saint Joseph Dr, Bloomington, IL. Use the map below to find directions or verify the practice location.

📍 308 Saint Joseph Dr, Bloomington, IL 61701-3506  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Justin James Holschbach. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1053623330. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Family Medicine036.132875IL
Family Medicine2012030856MO
Data Verified from CMS NPPES Last synced: 2026-06-15 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162