Individual provider Active NPI

Charina L Holmes, DC

  • Sports Physician Chiropractor
  • Monterey Park, CA
National Provider Identifier
1275533200
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
DC19151 Issued in CA
Practice address
257 W Pomona Blvd
Monterey Park, CA 91754-7120
Phone
(323) 728-3101
Fax
(323) 728-7284
NPI assigned
Aug 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X DC19151 CA Primary

Addresses

Primary practice location

257 W Pomona Blvd
Monterey Park, CA 91754-7120

Mailing address

257 W Pomona Blvd
Monterey Park, CA 91754-7120
Phone (323) 728-3101

Other identifiers 1

IdentifierTypeStateIssuer
DC01091510OtherCABLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081020000220 CA Practitioner - Chiropractic 3173681137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

257 W Pomona Blvd
Monterey Park, CA 91754-7120
Phone (323) 728-3101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC19151CAMDSports Physician Chiropractor
19151CAMDFamily Nurse Practitioner

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.

NPI Registry JSON

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

{
    "created_epoch": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1275533200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 W POMONA BLVD",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917547120",
            "telephone_number": "323-728-3101",
            "fax_number": "323-728-7284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 W POMONA BLVD",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917547120",
            "telephone_number": "323-728-3101",
            "fax_number": "323-728-7284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "CHARINA",
        "middle_name": "L",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-01",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC19151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "DC01091510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.