Individual provider Active NPI

Tabia Oni Holmes, ACNP

  • Gerontology Nurse Practitioner
  • North Charleston, SC
National Provider Identifier
1316547649
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
31666 Issued in SC
Practice address
7301 Rivers Ave Ste 182
North Charleston, SC 29406-4650
Phone
(854) 444-9552
NPI assigned
Oct 27, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LG0600X 31666 SC Primary

Addresses

Primary practice location

7301 Rivers Ave Ste 182
North Charleston, SC 29406-4650

Mailing address

7301 Rivers Ave
North Charleston, SC 29406-4650
Phone (854) 444-9552

Other identifiers 1

IdentifierTypeStateIssuer
NONEMedicaidSC

Other names 1

  • Tabia McMullen Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.gracefulharmonymedspa.com Direct

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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
31666SCMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Graceful Harmony Medspa & Wellness LLC Multi-Specialty Current Accepting new patients
Graceful Harmony Medspa CurrentSince Sep 4, 2022 Accepting new patients
Graceful Harmony Medspa Inc Multi-Specialty CurrentSince Sep 4, 2022 Accepting new patients

Locations

2850 Ashley Phosphate Rd
Ste A
North Charleston, SC 29418
Phone (843) 817-1744

7301 Rivers Ave
Ste 182
North Charleston, SC 29406
Phone (803) 809-8149

Organizations & group practices 3

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": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1316547649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 RIVERS AVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294064650",
            "telephone_number": "854-444-9552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 RIVERS AVE STE 182",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294064650",
            "telephone_number": "854-444-9552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "TABIA",
        "middle_name": "ONI",
        "credential": "ACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-27",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "31666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NONE",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.gracefulharmonymedspa.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7301 Rivers Ave Ste 182",
            "city": "North Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294064650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TABIA",
            "last_name": "MCMULLEN",
            "credential": "APRN-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.