Active NPI
Alexis Holmes
- Prevention Professional
- Bronx, NY
National Provider Identifier
1053118521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- License
- 3770595
- Practice address
- 1641 Taylor Ave Apt 1
Bronx, NY 10460-2714 - Phone
- (347) 301-5742
- NPI assigned
- Mar 3, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prevention Professional | 405300000X | 3770595 | NY | Primary |
Addresses
Primary practice location
1641 Taylor Ave Apt 1
Bronx, NY 10460-2714
Mailing address
1641 Taylor Ave Apt 1
Bronx, NY 10460-2714
Phone (347) 301-5742
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3770595 | NY | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740960000000",
"number": "1053118521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1641 TAYLOR AVE APT 1",
"city": "BRONX",
"state": "NY",
"postal_code": "104602714",
"telephone_number": "347-301-5742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1641 TAYLOR AVE APT 1",
"city": "BRONX",
"state": "NY",
"postal_code": "104602714",
"telephone_number": "347-301-5742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMES",
"first_name": "ALEXIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-03",
"last_updated": "2025-03-03",
"certification_date": "2025-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "NY",
"license": "3770595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.