Active NPI
Grace Holmes
- Behavior Technician
- Beavercreek, OH
National Provider Identifier
1417654757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB884655
- Practice address
- 1195 Meadow Bridge Dr
Beavercreek, OH 45434-4301 - Phone
- (937) 306-8811
- NPI assigned
- Feb 7, 2023
- Last updated
- Feb 7, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | BACB884655 | OH | Primary |
Addresses
Primary practice location
1195 Meadow Bridge Dr
Beavercreek, OH 45434-4301
Mailing address
650 White Oak Dr
Springfield, OH 45504-4171
Phone (937) 460-1840
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BACB884655 | OH | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675728000000",
"number": "1417654757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 WHITE OAK DR",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455044171",
"telephone_number": "937-460-1840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1195 MEADOW BRIDGE DR",
"city": "BEAVERCREEK",
"state": "OH",
"postal_code": "454344301",
"telephone_number": "937-306-8811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMES",
"first_name": "GRACE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-07",
"last_updated": "2023-02-07",
"certification_date": "2023-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "OH",
"license": "BACB884655",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beavercreek, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.