Individual provider Active NPI

Christina Joanne Holmes, PA-C

  • Physician Assistant
  • Byron Center, MI
National Provider Identifier
1003101692
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006049 Issued in MI
Practice address
2373 64TH St SW Ste 2700
Byron Center, MI 49315-7978
Phone
(616) 465-5910
NPI assigned
Jun 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601006049 MI Primary

Addresses

Primary practice location

2373 64TH St SW Ste 2700
Byron Center, MI 49315-7978

Mailing address

2373 64TH St SW Ste 2700
Byron Center, MI 49315-7978

Other names 1

  • Christina Joanne Keller Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111025000038 MI Practitioner - Physician Assistant 4688847361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantage Health/Saint Mary'S Medical GroupGroup PAC ID 4082807961, 499 clinicians

Practice addresses (Care Compare)

10047 Crossroad CT SE
Caledonia, MI 49316-7316
Phone (616) 685-8850

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone (616) 685-5000

Hospital & facility affiliations

  • Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601006049MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary'S Medical Group Physician Assistant CurrentSince Jun 17, 2023 Accepting new patients
River Valley Orthopedics, P.C. CurrentSince Jan 4, 2012 Accepting new patients
Advantage Health Saint Mary'S Medical Group PastSince Mar 12, 2023 Accepting new patients
Professional Pain Management PC Past Accepting new patients

Locations

2373 64th St SW
Ste 2700
Byron Center, MI 49315
Phone (616) 465-5910

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

350 Lafayette Ave SE
Fl 4
Grand Rapids, MI 49503
Phone (616) 456-8515

1111 Leffingwell Ave NE
Ste 100
Grand Rapids, MI 49525
Phone 61645971011381

1111 Leffingwell Ave NE
Grand Rapids, MI 49525
Phone 61645971011381

Interoperability endpoints

  • Direct secure messaging: cholmes36697@direct.trinity-health.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1003101692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2373 64TH ST SW STE 2700",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493157978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2373 64TH ST SW STE 2700",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493157978",
            "telephone_number": "616-465-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "CHRISTINA",
        "middle_name": "JOANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-13",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "KELLER",
            "middle_name": "JOANNE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Byron Center, MI

Sources for this page

Verify at the official NPI Registry.