Ernest Samuel Holmes IV, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

115096 Issued in MO

Practice address

336 S Jefferson St
Neosho, MO 64850-1769

Phone

(417) 451-0778

Fax

(417) 451-0779

NPI assigned

Jul 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Freeman Neosho Hospital

  • Internal Medicine Physician
  • Neosho, MO
  • NPI 1083045686

  Pediatrics

  Medicare reassignment NPD
• Freeman Neosho Hospital

  • Rural Health Clinic/Center
  • Anderson, MO
  • NPI 1437513686
  NPD

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297900800000",
    "number": "1316977804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3810",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "64803",
            "telephone_number": "417-451-0778",
            "fax_number": "417-451-0779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 S JEFFERSON ST",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648501769",
            "telephone_number": "417-451-0778",
            "fax_number": "417-451-0779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "ERNEST",
        "middle_name": "SAMUEL",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2011-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "115096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100149160A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100317780A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203756804",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "115234",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia D. Hester, LPC
• Kyslea Ann Hester, OTR/L
• Amy Hillmon
• Hillside Family Dental
• Kelsey Lynn Hobbs, DNP, APRN
• Kathryn J Housh, RDH
• Kathleen Howe
• Erika Michelle Jennings, PTA
• Jessica Laveroni Raye Jessica Laveroni
• John a. Yuhas, M.D., P.C.

• Pediatrics Physician in Neosho, MO
• Providers in Neosho, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.