Individual provider Active NPI

Lisa B Holmes, N.P.

  • Family Nurse Practitioner
  • Bloomington, IN
National Provider Identifier
1235158148
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71001972A Issued in IN
Practice address
583 S Clarizz Blvd
Bloomington, IN 47401-5515
Phone
(812) 333-9331
Fax
(812) 349-9201
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71001972A IN Primary

Addresses

Primary practice location

583 S Clarizz Blvd
Bloomington, IN 47401-5515

Mailing address

583 S Clarizz Blvd
Bloomington, IN 47401-5515
Phone (812) 333-9331

Other identifiers 1

IdentifierTypeStateIssuer
200368440MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lholmes4@direct.iuhealth.org

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)
Enrolled
Credentials
Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: lholmes4@direct.iuhealth.org

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1235158148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "583 S CLARIZZ BLVD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474015515",
            "telephone_number": "812-333-9331",
            "fax_number": "812-349-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "583 S CLARIZZ BLVD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474015515",
            "telephone_number": "812-333-9331",
            "fax_number": "812-349-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "LISA",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71001972A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200368440",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lholmes4@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "583 S Clarizz Blvd",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474015515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.