Individual provider Active NPI

Madge Clare Holmes, PHD

  • Marriage & Family Therapist
  • Colorado Springs, CO
National Provider Identifier
1396931630
Registry record updated Aug 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
855 Issued in CO
Practice address
4157 Zurich Dr
Colorado Springs, CO 80920-7524
Phone
(719) 282-6248
Fax
(719) 282-6249
NPI assigned
Sep 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 25576 CA
Registered Nurse 163W00000X 164515 CA
Marriage & Family Therapist 106H00000X 855 CO Primary

Addresses

Primary practice location

4157 Zurich Dr
Colorado Springs, CO 80920-7524

Mailing address

4157 Zurich Dr
Colorado Springs, CO 80920-7524
Phone (719) 282-6248

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250319003208 CO Practitioner - Marriage and Family Therapist 2769624055 Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
25576CAMDMarriage & Family Therapist
164515CAMDRegistered Nurse
855COMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438732800000",
    "number": "1396931630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4157 ZURICH DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207524",
            "telephone_number": "719-282-6248",
            "fax_number": "719-282-6249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4157 ZURICH DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207524",
            "telephone_number": "719-282-6248",
            "fax_number": "719-282-6249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "MADGE",
        "middle_name": "CLARE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-20",
        "last_updated": "2015-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "25576",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "164515",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CO",
            "license": "855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.