Individual provider Active NPI

Alysabeth Vititoe Holmes, PA-C

  • Physician Assistant
  • Panama City, FL
National Provider Identifier
1164206348
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9118173 Issued in FL
Practice address
120 N Richard Jackson Blvd
Panama City, FL 32407-2521
Phone
(850) 804-3600
Fax
(850) 804-3601
NPI assigned
Aug 21, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9118173 FL Primary

Addresses

Primary practice location

120 N Richard Jackson Blvd
Panama City, FL 32407-2521

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6063

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240611002268 FL Practitioner - Physician Assistant 6305388992 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Associates of Pensacola PAGroup PAC ID 2365422664, 40 clinicians

Practice addresses (Care Compare)

5147 N 9TH Ave
Suite 311
Pensacola, FL 32504-8770
Phone (850) 436-4563

Hospital & facility affiliations

  • Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025
  • Ascension Sacred Heart Bay Hospital, Panama City, FL, CCN 100026
  • Baptist Hospital Hospital, Pensacola, FL, CCN 100093
  • Sacred Heart Hospital on the Emerald Coast Hospital, Miramar Beach, FL, CCN 100292

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Associates of Pensacola PA CurrentSince Apr 1, 2026 Accepting new patients
Sacred Heart Health System Inc CurrentSince Feb 20, 2025 Accepting new patients
Gastroenterology Associates of Pensacola PA CurrentSince Apr 1, 2026 Accepting new patients
Sacred Heart Health System, Inc. CurrentSince Feb 20, 2025 Accepting new patients

Locations

36500 Emerald Coast Pkwy
Destin, FL 32541
Phone (850) 269-0301

26 Racetrack Rd NW
Ft Walton Bch, FL 32547
Phone (850) 416-2340

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

120 N Richard Jackson Blvd
Panama City Beach, FL 32407
Phone (850) 233-6922

5147 N 9th Ave
Ste 311
Pensacola, FL 32504

Interoperability endpoints

  • Direct secure messaging: alysabeth.holmes.1@9582.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1164206348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6063",
            "fax_number": "904-539-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N RICHARD JACKSON BLVD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324072521",
            "telephone_number": "850-804-3600",
            "fax_number": "850-804-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "ALYSABETH",
        "middle_name": "VITITOE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.