Active NPI
Robert Michael Holmes, MD
- Internal Medicine Physician
- Lafayette, IN
National Provider Identifier
1336161629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 01029025
- Practice address
- 3920 St Francis Way
Suite 209
Lafayette, IN 47905-4917 - Phone
- (765) 775-2860
- Fax
- (765) 775-2826
- NPI assigned
- Jul 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 01029025 | IN | Primary |
Addresses
Primary practice location
3920 St Francis Way
Suite 209
Lafayette, IN 47905-4917
Mailing address
1415 Salem St
Suite 302
Lafayette, IN 47904-2099
Phone (765) 449-2410
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100232090 | Medicaid | IN |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01029025 | IN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Franciscan Physician Network | Internal Medicine | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- Indianapolis, IN
- NPI 1225327984
Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310947200000",
"number": "1336161629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1415 SALEM ST",
"address_2": "SUITE 302",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479042099",
"telephone_number": "765-449-2410",
"fax_number": "765-742-8607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3920 ST FRANCIS WAY",
"address_2": "SUITE 209",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479054917",
"telephone_number": "765-775-2860",
"fax_number": "765-775-2826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMES",
"first_name": "ROBERT",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2011-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "01029025",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100232090",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.