Individual provider Active NPI

Steven Lance Holmes, M.D.

  • General Practice Physician
  • Port St John, FL
National Provider Identifier
1194795872
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME152516 Issued in FL
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

Updated by the provider on May 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0500X ME152516 FL
Occupational Medicine Physician 2083X0100X 09828R LA
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
203568600MedicaidFL

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211012000369 FL Practitioner - General PracticePractitioner - Preventive Medicine 4082899182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Preventive Medicine
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 62 clinicians

Practice addresses (Care Compare)

390 Challenger Rd
Cape Canaveral, FL 32920-4200
Phone (321) 268-6834

Hospital & facility affiliations

  • Parrish Medical Center Hospital, Titusville, FL, CCN 100028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
09828RLAMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Brevard Medical Support, Inc Multi-Specialty CurrentSince Nov 21, 2021 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 1

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": "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

Verify at the official NPI Registry.