Individual provider Active NPI

William R Holmes, D.O.

  • Family Medicine Physician
  • Lewistown, MT
National Provider Identifier
1053302794
Registry record updated Dec 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5370 Issued in MT
Practice address
408 Wendell Ave
Lewistown, MT 59457-2261
Phone
(406) 535-1502
NPI assigned
Nov 2, 2005
Last updated
Dec 12, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5370 MT Primary

Addresses

Primary practice location

408 Wendell Ave
Lewistown, MT 59457-2261

Mailing address

408 Wendell Ave
Lewistown, MT 59457-2261
Phone (406) 535-1502

Other identifiers 2

IdentifierTypeStateIssuer
00521OtherMTBCBS
043843MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041014000938 MT Practitioner - Family Practice 4880654763 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5370MTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Montana Medical Facilities, Inc. Family Medicine CurrentSince Oct 9, 2017 Accepting new patients
Central Montana Medical Facilities, Inc. Family Medicine Current Accepting new patients
Central Montana Medical Facilities, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Central Montana Medical Facilities, Inc CurrentSince Oct 9, 2017 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

310 Wendell Ave
Ste 103
Lewistown, MT 59457
Phone (406) 535-1480

408 Wendell Ave
Lewistown, MT 59457
Phone (406) 535-1502

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, 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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1053302794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 WENDELL AVE",
            "city": "LEWISTOWN",
            "state": "MT",
            "postal_code": "594572261",
            "telephone_number": "406-535-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 WENDELL AVE",
            "city": "LEWISTOWN",
            "state": "MT",
            "postal_code": "594572261",
            "telephone_number": "406-535-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "5370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00521",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043843",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewistown, MT

Sources for this page

Verify at the official NPI Registry.