Individual provider Active NPI

Nina Sophia Holmes, RN

  • Registered Nurse
  • Hillsboro, OR
National Provider Identifier
1003776774
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
10042686 Issued in OR
Practice address
5555 NE Elam Young Pkwy
Hillsboro, OR 97124-6452
Phone
(503) 216-1600
Fax
(503) 216-1610
NPI assigned
Nov 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 61649435 WA
Registered Nurse 163W00000X 10042686 OR Primary

Addresses

Primary practice location

5555 NE Elam Young Pkwy
Hillsboro, OR 97124-6452

Mailing address

5555 NE Elam Young Pkwy
Hillsboro, OR 97124-6452
Phone (503) 216-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
10042686ORMDRegistered Nurse
61649435WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1763078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1003776774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 NE ELAM YOUNG PKWY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971246452",
            "telephone_number": "503-216-1600",
            "fax_number": "503-216-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 NE ELAM YOUNG PKWY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971246452",
            "telephone_number": "503-216-1600",
            "fax_number": "503-216-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "NINA",
        "middle_name": "SOPHIA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-14",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "61649435",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "10042686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.