Individual provider Active NPI

Clarence Anthony Holmes Sr., PT

  • Physical Therapist
  • Cleveland, MS
National Provider Identifier
1023455011
Registry record updated Sep 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
362 Issued in MS
Practice address
506 3Rd St
Cleveland, MS 38732-2362
Phone
(662) 843-0076
Fax
(662) 846-7730
NPI assigned
May 30, 2013
Last updated
Sep 6, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 362 MS Primary

Addresses

Primary practice location

506 3Rd St
Cleveland, MS 38732-2362

Mailing address

506 Third St.
Cleveland, MS 38732-2367
Phone (662) 843-0076

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
362MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Natural Pain Back Institute, LLC Physical Therapist Past Accepting new patients
J and R Chiropractic Inc. PastSince Aug 11, 2013 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1023455011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 THIRD ST.",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322367",
            "telephone_number": "662-843-0076",
            "fax_number": "662-846-7730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 3RD ST",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322362",
            "telephone_number": "662-843-0076",
            "fax_number": "662-846-7730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "CLARENCE",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-30",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2013; 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.