Active NPI
Steven Lance Holmes, M.D.
- General Practice Physician
- Port St John, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- ME152516
- Practice address
- 5005 Port St John Pkwy
Port St John, FL 32927-4305 - Phone
- (321) 633-8640
- Fax
- (321) 633-8641
- NPI assigned
- Jan 25, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Preventive Medicine/Occupational Environmental Medicine Physician | 2083P0500X | ME152516 | FL | |
| Occupational Medicine Physician | 2083X0100X | 09828R | LA | |
| General Practice Physician | 208D00000X | ME152516 | FL | Primary |
Addresses
Primary practice location
5005 Port St John Pkwy
Port St John, FL 32927-4305
Mailing address
805 Century Medical Dr Ste C
Titusville, FL 32796-2100
Phone (321) 268-6264
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 203568600 | Medicaid | FL |
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211012000369 | FL | Practitioner - General Practice | 4082899182 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- Wayne State University School of Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- North Brevard Medical Support Inc
Practice addresses (Care Compare)
390 Challenger Rd
Cape Canaveral, FL 32920-4200
Phone (321) 268-6834
Hospital & facility affiliations
- Parrish Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09828R | LA | MD | Occupational Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Brevard Medical Support, Inc | Multi-Specialty | Current | Accepting new patients |
Locations
390 Challenger Rd
Port Canaveral, FL 32920
Phone (321) 633-8640
5005 Port St John Pkwy
Port St John, FL 32927
Phone (321) 504-0556
951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511
805 Century Medical Dr
Ste C
Titusville, FL 32796
Phone (321) 268-6264
Interoperability endpoints
- steven.holmes.1@17832.direct.athenahealth.com
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Titusville, FL
- NPI 1609834886
FL, Multi-Specialty
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Titusville, FL
- NPI 1053424648
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748390400000",
"number": "1194795872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 CENTURY MEDICAL DR STE C",
"city": "TITUSVILLE",
"state": "FL",
"postal_code": "327962100",
"telephone_number": "321-268-6264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5005 PORT ST JOHN PKWY",
"city": "PORT ST JOHN",
"state": "FL",
"postal_code": "329274305",
"telephone_number": "321-633-8640",
"fax_number": "321-633-8641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMES",
"first_name": "STEVEN",
"middle_name": "LANCE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-25",
"last_updated": "2025-05-28",
"certification_date": "2025-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
"state": "FL",
"license": "ME152516",
"primary": false
},
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "LA",
"license": "09828R",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": "FL",
"license": "ME152516",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "203568600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Port St John, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.