Active NPI
Charisse Holmes
- Family Nurse Practitioner
- Dublin, GA
National Provider Identifier
1073084877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN216446
- Practice address
- 2400 Bellevue Rd Ste 2
Dublin, GA 31021-2885 - Phone
- (478) 272-8580
- NPI assigned
- Dec 6, 2018
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN216446 | GA | Primary |
Addresses
Primary practice location
2400 Bellevue Rd Ste 2
Dublin, GA 31021-2885
Mailing address
2400 Bellevue Rd Ste 2
Dublin, GA 31021-2885
Phone (478) 272-8580
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616025600000",
"number": "1073084877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 BELLEVUE RD STE 2",
"city": "DUBLIN",
"state": "GA",
"postal_code": "310212885",
"telephone_number": "478-272-8580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 BELLEVUE RD STE 2",
"city": "DUBLIN",
"state": "GA",
"postal_code": "310212885",
"telephone_number": "478-272-8580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMES",
"first_name": "CHARISSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-06",
"last_updated": "2021-03-18",
"certification_date": "2021-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "RN216446",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dublin, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.