Active NPI
Rudolph Holmes, MA LIC SW
- Social Worker
- Minneapolis, MN
National Provider Identifier
1144352162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 8534
- Practice address
- 2301 Thomas Ave N
Minneapolis, MN 55411-2355 - Phone
- (612) 251-5738
- NPI assigned
- Mar 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 8534 | MN | Primary |
Addresses
Primary practice location
2301 Thomas Ave N
Minneapolis, MN 55411-2355
Mailing address
2301 Thomas Ave N
Minneapolis, MN 55411-2355
Phone (612) 251-5738
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 113136 | Other | MN | HEALTHPARTNERS OF MN |
| 3G739HO | Other | MN | BLUE CROSS BLUE SHIELD MN |
| 8534 | Other | MN | STATE LICENSE |
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8534 | MN | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1144352162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 THOMAS AVE N",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554112355",
"telephone_number": "612-251-5738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 THOMAS AVE N",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554112355",
"telephone_number": "612-251-5738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMES",
"first_name": "RUDOLPH",
"name_prefix": "Mr.",
"credential": "MA LIC SW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-12",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MN",
"license": "8534",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS OF MN",
"identifier": "113136",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD MN",
"identifier": "3G739HO",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "8534",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.