Active NPI
Krisandra Jolynne Holmes, LPN
- Licensed Practical Nurse
- Springfield, IL
National Provider Identifier
1205533015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 043111130
- Practice address
- 2027 N 21St St
Springfield, IL 62702-1918 - Phone
- (217) 685-7447
- NPI assigned
- Feb 13, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 043111130 | IL | Primary |
Addresses
Primary practice location
2027 N 21St St
Springfield, IL 62702-1918
Mailing address
2027 N 21St St
Springfield, IL 62702-1918
Phone (217) 685-7447
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043111130 | IL | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676246400000",
"number": "1205533015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2027 N 21ST ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627021918",
"telephone_number": "217-685-7447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2027 N 21ST ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627021918",
"telephone_number": "217-685-7447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMES",
"first_name": "KRISANDRA",
"middle_name": "JOLYNNE",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-13",
"last_updated": "2023-02-13",
"certification_date": "2023-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "IL",
"license": "043111130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.