Individual provider Active NPI

Denis R Holmes, OD

  • Optometrist
  • Summerville, SC
National Provider Identifier
1114913589
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2308 Issued in SC
Practice address
9770 Dorchester Rd Unit 101
Summerville, SC 29485-7541
Phone
(843) 767-2328
NPI assigned
Sep 21, 2005
Reactivated
Mar 30, 2006
Last updated
Jul 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2308 SC Primary
Optometrist 152W00000X 18004480A IN
Optometrist 152W00000X 1594 WA

Addresses

Primary practice location

9770 Dorchester Rd Unit 101
Summerville, SC 29485-7541

Mailing address

4 Village Row Unit 413
Beaufort, SC 29906-7507
Phone (360) 319-7680

Other identifiers 3

IdentifierTypeStateIssuer
410004982OtherWARR MEDICARE
001446200OtherWAMEDICARE
2008191MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, SC, IN, OH4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20100519000553 WA Practitioner - Optometry 3173652856 Reassigns benefits to 3 organizations
I20220328002046 SC Practitioner - Optometry 3173652856 Reassigns benefits to 1 organization
I20240429002802 IN Practitioner - Optometry 3173652856 Reassigns benefits to 3 organizations
I20240501003703 OH Practitioner - Optometry 3173652856 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1594WAMDOptometrist
2308SCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Indiana, LLC Optometrist Current Accepting new patients
Aeg Ohio Professional PC Optometrist CurrentSince Mar 11, 2024 Accepting new patients
Vision Health PLLC Optometrist CurrentSince May 25, 2024 Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Apr 24, 2024 Accepting new patients
Family First Vision Care Kentucky, LLC Optometrist CurrentSince Apr 30, 2024 Accepting new patients
Northeastern Washington Eyecare Optometrist CurrentSince Oct 15, 2024 Accepting new patients
Optic One Eye Care Centers of Spokane PC Optometrist CurrentSince Oct 5, 2015 Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Apr 24, 2024 Accepting new patients
Aeg Ohio Professional PC Optometrist CurrentSince Mar 11, 2024 Accepting new patients
Aeg Washington Professional PC Optometrist Past Accepting new patients
F Mason Smith Optometrist Past Accepting new patients

Locations

2224 Cassopolis St
Elkhart, IN 46514
Phone (574) 206-1533

5405 Pearl Dr
Ste 4
Evansville, IN 47712
Phone (812) 426-2066

9760 Lantern Rd
Fishers, IN 46037
Phone (317) 577-9200

316 S Hamilton Rd
Gahanna, OH 43230

33541 Aurora Rd
Solon, OH 44139
Phone (440) 248-2020

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

102 S Oak St
Colville, WA 99114
Phone (509) 684-5278

205 S Washington Ave
Newport, WA 99156
Phone (509) 447-2945

1720 N Hamilton St
Spokane, WA 99207
Phone (509) 328-2632

513 E Hastings Rd
Spokane, WA 99218
Phone (509) 468-5074

5164 Capitol Blvd SE
Tumwater, WA 98501
Phone (360) 357-3410

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1114913589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 VILLAGE ROW UNIT 413",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299067507",
            "telephone_number": "360-319-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9770 DORCHESTER RD UNIT 101",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294857541",
            "telephone_number": "843-767-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "DENIS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "deactivation_date": "2006-03-24",
        "reactivation_date": "2006-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2308",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004480A",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1594",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "410004982",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "001446200",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2008191",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.