Active NPI
Cody Holmes
- Family Medicine Physician
- Tampa, FL
National Provider Identifier
1437612181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 33263
- Practice address
- 3250 Zemke Ave BLDG 1078
Tampa, FL 33621-5023 - Phone
- (813) 827-9030
- NPI assigned
- Apr 10, 2019
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 33263 | NE | Primary |
Addresses
Primary practice location
3250 Zemke Ave BLDG 1078
Tampa, FL 33621-5023
Mailing address
302 N Holly Rd
Olney, IL 62450-3336
Phone (618) 919-1495
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210506000168 | FL | Order and Referring Only - Family Practice | 8628487550 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33263 | NE | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692576000000",
"number": "1437612181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 N HOLLY RD",
"city": "OLNEY",
"state": "IL",
"postal_code": "624503336",
"telephone_number": "618-919-1495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3250 ZEMKE AVE BLDG 1078",
"city": "TAMPA",
"state": "FL",
"postal_code": "336215023",
"telephone_number": "813-827-9030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMES",
"first_name": "CODY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-10",
"last_updated": "2023-08-21",
"certification_date": "2023-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NE",
"license": "33263",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.