Kenneth Winston Holmes, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

036-078410 Issued in IL

Practice address

3330 W 177TH St
Suite 3C
Hazel Crest, IL 60429-2001

Phone

(708) 799-6799

NPI assigned

Apr 19, 2006

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 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL

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.

Enrollment records 1

Specialty

Neurology

Education

University of Chicago, Pritzker School of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Neurology Consultants, S.C.Group PAC ID 8628039534, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Trinity Hospital Hospital, Chicago, IL, CCN 140048

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kholmes277501@direct.myadvocateaurora.org
• FHIR API: https://fhir4.healow.com/fhir/r4/EJIABA/Endpoint/EJIABA

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.

• Neurology Consultants, S.C.

  • Neurology Physician
  • Hazel Crest, IL
  • NPI 1730294943
  Medicare reassignment Care Compare group NPD Authorized official
• R G Welch Neurology Consultant & Assoc LTD

  • Neurology Physician
  • Belleville, IL
  • NPI 1205855319
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Advocate Health and Hospitals Corporation

  dba Advocate South Suburban Hospital

  • General Acute Care Hospital
  • Hazel Crest, IL
  • NPI 1467560128
  Care Compare affiliation
• Advocate Health and Hospitals Corporation

  dba Advocate South Suburban Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1558479212
  Care Compare affiliation

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1114982477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 W 177TH ST",
            "address_2": "SUITE 3C",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292001",
            "telephone_number": "708-799-6799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 W 177TH ST",
            "address_2": "SUITE 3C",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292001",
            "telephone_number": "708-799-6799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "KENNETH",
        "middle_name": "WINSTON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036-078410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0363796086",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kholmes277501@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3330 W 177th St",
            "address_2": "Suite 3C",
            "city": "Hazel Crest",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604292001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3330 W 177th St",
            "address_2": "Suite 3C",
            "city": "Hazel Crest",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604292001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicole Judith Hill
• Tara Hill
• Lisa Hines, PHD., LCSW, LPHA
• Ethan Hoeldtke, PA-C
• Stacey Hogroe
• Home Bound Healthcare, Inc. (Home Bound Healthcare Medical Equipment and Supplies)
• Kimberly Hough
• Lee Edward Houston, CADC
• Rama Hritani, MD
• Michael Humble, MASSAGE THERAPIST

• Specialist in Hazel Crest, IL
• Providers in Hazel Crest, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.