Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Coty John Holm

Individual provider Surgical Physician Assistant · NPI 1902453855

Coty John Holm is a Physician Assistant in Missoula, Montana. Qualified in 2020, 6 years ago. Practices with Providence Health and Services Mt, a 358-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Montana.

Years since qualifying
6
Licensed in
MT
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

500 W Broadway St
Missoula, MT 59802-4008
Phone: (406) 329-5615
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4311 11th Avenue Ne, Seattle, WA 98105-6367 — (206) 616-4001

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence MED-PAC-LIC-91036 (MT)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1902453855
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 23, 2019
Last updated in NPPESMay 21, 2021
Certification dateMay 21, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Providence Health And Services Mt — 358 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients245
Services billed 333 a service is one billed item, such as a visit, a test or a procedure
Average patient age76

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Providence Health and Services Mt

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 358 clinicians in the practice; 12 are shown here.

Other providers in Missoula