Individual provider Active NPI

Isreal Cornelius Holmes, STAR OF DAVID

  • Secured Medical Transport (VAN)
  • Pearland, TX
National Provider Identifier
1053718296
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Secured Medical Transport (VAN)Taxonomy code 343800000X
Practice address
3122 Springdale Dr
Pearland, TX 77584-5101
Phone
(832) 275-2686
Fax
(866) 292-3523
NPI assigned
Dec 3, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Secured Medical Transport (VAN) 343800000X Primary
Driver 172A00000X
Private Vehicle 347C00000X
Transportation Broker 347E00000X

Addresses

Primary practice location

3122 Springdale Dr
Pearland, TX 77584-5101

Mailing address

3122 Springdale Dr
Pearland, TX 77584-5101
Phone (832) 275-2686

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

Practice roles

OrganizationSpecialtyStatusNew patients
Star of David Home Healthcare CurrentSince Feb 9, 2020 Accepting new patients
Star of David Inc Secured Medical Transport (Van) Current 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1417564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1053718296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3122 SPRINGDALE DR",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775845101",
            "telephone_number": "832-275-2686",
            "fax_number": "866-292-3523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3122 SPRINGDALE DR",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775845101",
            "telephone_number": "832-275-2686",
            "fax_number": "866-292-3523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "ISREAL",
        "middle_name": "CORNELIUS",
        "credential": "STAR OF DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-03",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347E00000X",
            "taxonomy_group": "",
            "desc": "Transportation Broker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.