Dominique Holmes, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209024564 Issued in IL

Practice address

1 S. 376 Summit Ave Court D
Oakbrook Terrace, IL 60181

Phone

(773) 238-2828

NPI assigned

Aug 6, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, VT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Gifford Health Care IncGroup PAC ID 2668624982, 37 clinicians

Rodasi LLCGroup PAC ID 0749418630, 34 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gifford Medical Center Hospital, Randolph, VT, CCN 471301

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Rodasi LLC

  • Mental Health Counselor
  • Hoffman Estates, IL
  • NPI 1467691790

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Gifford Health Care, Inc

  • General Practice Physician
  • Randolph, VT
  • NPI 1013269430
  Medicare reassignment Care Compare group NPD
• Psychology Center P.C.

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1396735361
  NPD
• Gifford Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Randolph, VT
  • NPI 1831782929
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Gifford Medical Center Inc

  • Critical Access Hospital
  • Randolph, VT
  • NPI 1730199647
  Care Compare affiliation

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1427668151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7758 S PEORIA ST APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606202824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S. 376 SUMMIT AVE COURT D",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "60181",
            "telephone_number": "773-238-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "DOMINIQUE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-06",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "IL",
            "license": "041460162",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209024564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Domholmes.np@gmail.com",
            "affiliation": "N",
            "address_1": "10343 S Western Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606432410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• HNHC, PLLC
• Vy Huong Hoang, DC
• Nicole Hoder
• Aleda Jordyn Hoffman, PSYD
• Mary Holland, PSY.D.
• Homebound Physicians LLC
• Hope Health Care Services Inc
• Donnisha Hoskins
• Leona M Hubatch, PH.D., CCC
• Jawwad Hussain, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Oakbrook Terrace, IL
• Providers in Oakbrook Terrace, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.