Organization Active NPI

Holmes Family Practice PA

  • Clinic/Center
  • Lake Wales, FL
National Provider Identifier
1407045487
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
HOLMES FAMILY PRACTICE PA
Practice address
455 Emerald Ave
Lake Wales, FL 33853-4716
Phone
(863) 676-0014
Fax
(863) 676-0090
NPI assigned
Oct 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Authorized official

Name
David Lynn Holmes, D.O.
Title
President
Phone
(863) 676-0014

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

455 Emerald Ave
Lake Wales, FL 33853-4716

Mailing address

455 Emerald Ave
Lake Wales, FL 33853-4716
Phone (863) 676-0014

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1407045487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 EMERALD AVE",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534716",
            "telephone_number": "863-676-0014",
            "fax_number": "863-676-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 EMERALD AVE",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534716",
            "telephone_number": "863-676-0014",
            "fax_number": "863-676-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLMES FAMILY PRACTICE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-16",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-676-0014",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.