Ryan Holmes
Individual provider Active NPI Internal Medicine Physician · Hillsdale, MI
NPI 1225541014 · NPPES record last updated Nov 15, 2017
Key facts
- NPI
- 1225541014
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 5601008467 (MI)
- Practice address
- 3271 W Carleton Rd
Hillsdale, MI 49242-9458 - Phone
- (517) 437-8637
- NPI assigned
- Nov 15, 2017
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 11
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180103001453 | MI | Practitioner - Physician Assistant | 7810255460 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601008467 | MI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Joseph Mercy Hospital | Current |
Accepting new patients | |
| Saint Joseph Mercy Livingston Hospital | Current |
Accepting new patients | |
| St Joseph Mercy Hospital | Internal Medicine | Current |
Accepting new patients |
| Advanced Veins and Vascular Management PLC | Past | Accepting new patients | |
| St Joseph Mercy Hospital | Past | Accepting new patients |
Locations
620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450
5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EIBIBD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 5601008467 | MI | Yes |
Addresses
Primary practice location
3271 W Carleton Rd
Hillsdale, MI 49242-9458
Mailing address
4964 Birkdale Dr
Ann Arbor, MI 48103-9743
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1167313676 | Medicaid | MI |
Other providers in Hillsdale, MI
- Hillsdale Pediatrics Clinic PC
- Hillsdale Psychological Institute
- Hillsdale Pulmonary Critical Care and Sleep Medicine PC
- Hillsdale Smiles
- Hilltop Counseling
- Home Health & Wellness, LLC
- Amanda Rene'E Hood
- Hope for Developmental Disabilities
- Horizon Emergency Physicians, P. C.
- Hospice of Hillsdale County
All providers in Hillsdale, MI · Internal Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.