CATHERINE GRACE ENGIBOUS HOLDER PA-C
NPI 1790004844
Physician Assistant - Surgical in Fairfax, VA

Q: What is Catherine Holder's NPI number?

The NPI number for Catherine Holder is 1790004844. It was assigned to this individual provider in the NPPES registry on May 27, 2010.

Q: What is Catherine Holder's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Catherine Holder was last updated on July 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 27, 2010PECOS Enrolled

2710 PROSPERITY AVE STE 200, FAIRFAX, VA 22031(703) 280-2841(703) 280-4773 Get Directions Write a Review

NPPES record last updated: July 30, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Catherine Grace Engibous Holder Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CATHERINE GRACE ENGIBOUS HOLDER PA-C (NPI 1790004844) is an individual surgical provider in Fairfax, Virginia, licensed in (PA60511351) and active in the NPI registry since May 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790004844

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameCATHERINE GRACE ENGIBOUS HOLDERCredential: PA-C

Location Address2710 PROSPERITY AVE STE 200Fairfax, VA 22031-4358

Mailing Address7036 Quander RdAlexandria, VA 22307-1612 · (907) 240-2084

Phone(703) 280-2841

Fax(703) 280-4773

Sole ProprietorNo

Enumeration DateMay 27, 2010

Last NPPES UpdateJuly 30, 2021

NPPES CertifiedJuly 30, 2021

✔ NPI 1790004844 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed · PA60511351

Also ListedPhysician AssistantTaxonomy 363A00000X · License PA60511351 (WA)

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License PA60511351 (WA)

2710 PROSPERITY AVE STE 200, Fairfax, VA 22031

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Other Identifiers 2

OtherK163676Ptan

MedicaidMDA0380AK

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Catherine Grace Engibous Holder Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FAIRFAX COLON & RECTAL SURGERY CENTER, LLC

Clinic/Center (Ambulatory Surgical)