Individual provider Active NPI

Laura Geanine Holmes, MS, RD, LD, CDE

  • Registered Dietitian
  • Clarksburg, WV
National Provider Identifier
1083998728
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
747 Issued in WV
Practice address
1 Med Center Dr
Clarksburg, WV 26301-4155
Phone
(304) 623-3461
NPI assigned
Sep 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 747 WV Primary

Addresses

Primary practice location

1 Med Center Dr
Clarksburg, WV 26301-4155

Mailing address

205 Wood St
Clarksburg, WV 26301-3129
Phone (304) 544-0319

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
747WVMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1317254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1083998728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 WOOD ST",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263013129",
            "telephone_number": "304-544-0319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MED CENTER DR",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263014155",
            "telephone_number": "304-623-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "LAURA",
        "middle_name": "GEANINE",
        "name_prefix": "Mrs.",
        "credential": "MS, RD, LD, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-29",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WV",
            "license": "747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; 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.