Richard J Holmes, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

30867671205 Issued in UT

Practice address

2230 N University Pkwy
Suite 1a
Provo, UT 84604-1509

Phone

(801) 377-3413

Fax

(801) 655-1890

NPI assigned

Oct 5, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2013 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Cottontree Family Practice

  • Family Medicine Physician
  • Provo, UT
  • NPI 1407036189
  NPD (past)

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1083601942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 N UNIVERSITY PKWY",
            "address_2": "SUITE 1A",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846041509",
            "telephone_number": "801-377-3413",
            "fax_number": "801-655-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 N UNIVERSITY PKWY",
            "address_2": "SUITE 1A",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846041509",
            "telephone_number": "801-377-3413",
            "fax_number": "801-655-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "RICHARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "30867671205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMBA",
            "identifier": "356679",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004610165",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECTHEALTH",
            "identifier": "107008793104",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083601942",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID PIN",
            "identifier": "000057007",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0101468",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cutler Hollist
• Gilbert Jacob Holm
• Brad L. Holmes, D.D.S.
• Jeremy Holmes
• Kevin Christopher Holmes, M.D.
• Brooke Koyle Holst
• Brodie Anne Holt
• Jennifer Holt
• Katie Holt
• Terry Ivin Holt, MSC

• Family Medicine Physician in Provo, UT
• Providers in Provo, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.