Individual provider Active NPI

Lafitte Jermaine Holmes Sr., CLINICAL NURSE SPEC

  • Adult Health Clinical Nurse Specialist
  • San Antonio, TX
National Provider Identifier
1013217876
Registry record updated Oct 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
667360 Issued in TX
Practice address
4212 E Southcross Blvd
Ste # 145
San Antonio, TX 78222-3735
Phone
(210) 447-3033
Fax
(210) 447-3036
NPI assigned
Oct 27, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 667360 TX Primary

Addresses

Primary practice location

4212 E Southcross Blvd
Ste # 145
San Antonio, TX 78222-3735

Mailing address

4212 E Southcross Blvd
Ste # 145
San Antonio, TX 78222-3735
Phone (210) 447-3033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20110120000376 TX Practitioner - Certified Clinical Nurse Specialist (CNS) 7517156912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Antonio Premier Internal Medicine, PLLCGroup PAC ID 6608935366, 12 clinicians

Practice addresses (Care Compare)

1032 S WW White Rd
San Antonio, TX 78220-2531
Phone (210) 447-3033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
667360TXMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
San Antonio Premier Internal Medicine, PLLC CurrentSince Dec 14, 2010 Accepting new patients

Locations

4212 E Southcross Blvd
Ste 145
San Antonio, TX 78222
Phone (210) 337-6202

1032 S WW White Rd
San Antonio, TX 78220
Phone (210) 447-3033

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AGCFAA/Endpoint/AGCFAA

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1288137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288224000000",
    "number": "1013217876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4212 E SOUTHCROSS BLVD",
            "address_2": "STE # 145",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782223735",
            "telephone_number": "210-447-3033",
            "fax_number": "210-447-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 E SOUTHCROSS BLVD",
            "address_2": "STE # 145",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782223735",
            "telephone_number": "210-447-3033",
            "fax_number": "210-447-3036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "LAFITTE",
        "middle_name": "JERMAINE",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "CLINICAL NURSE SPEC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-27",
        "last_updated": "2010-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "TX",
            "license": "667360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.