Individual provider Active NPI

Grace D Holmes, M.D.

  • Family Medicine Physician
  • Norwich, NY
National Provider Identifier
1215994546
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
166300 Issued in NY
Practice address
55 Calvary Dr
Norwich, NY 13815-1032
Phone
(607) 336-6362
Fax
(607) 336-2028
NPI assigned
Apr 28, 2006
Last updated
Apr 8, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 166300 NY Primary

Addresses

Primary practice location

55 Calvary Dr
Norwich, NY 13815-1032

Mailing address

PO Box 725
Cooperstown, NY 13326-0725
Phone (607) 336-6362

Other identifiers 1

IdentifierTypeStateIssuer
01013496MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
166300NYMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1215994546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 725",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133260725",
            "telephone_number": "607-336-6362",
            "fax_number": "607-336-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CALVARY DR",
            "city": "NORWICH",
            "state": "NY",
            "postal_code": "138151032",
            "telephone_number": "607-336-6362",
            "fax_number": "607-336-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "GRACE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "166300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01013496",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, NY

Sources for this page

Verify at the official NPI Registry.