Individual provider Active NPI

Christy R Holmes, NP

  • Nurse Practitioner
  • Carbondale, IL
National Provider Identifier
1508373770
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
277002112 Issued in IL
Practice address
305 W Jackson St Ste 301
Carbondale, IL 62901-1474
Phone
(618) 529-0520
Fax
(618) 529-0519
NPI assigned
Jan 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 277002112 IL Primary

Addresses

Primary practice location

305 W Jackson St Ste 301
Carbondale, IL 62901-1474

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cholmes13505@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180420002130 IL Practitioner - Nurse Practitioner 9931462181 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kidney Disease and Medicine Specialty Consultants LLCGroup PAC ID 1052391521, 6 clinicians

Practice addresses (Care Compare)

1350 Cedar CT
Carbondale, IL 62901-5336
Phone (618) 529-2955

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.38 of 100Reported as group
Quality
31.67
Improvement activities
40
Cost
75.71

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
55.9
Promoting interoperability
100
Improvement activities
40
Cost
72.01

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Medical Services, NFP CurrentSince Aug 22, 2022 Accepting new patients
Kidney Disease and Medicine Specialty Consultants LLC CurrentSince Mar 6, 2018 Accepting new patients

Locations

1151 Route 14 W
Benton, IL 62812
Phone (618) 435-4850

405 W Jackson St
Carbondale, IL 62901

305 W Jackson St
Ste 301
Carbondale, IL 62901
Phone (618) 529-0520

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

1350 Cedar Ct
Carbondale, IL 62901
Phone (618) 457-0402

1900 State St
Chester, IL 62233
Phone (618) 826-2388

102 Memorial Dr
Chester, IL 62233
Phone (618) 826-4411

900 N Washington St
Du Quoin, IL 62832
Phone (618) 542-1050

4 W Main St
Du Quoin, IL 62832
Phone (618) 542-6477

275 Small St
Harrisburg, IL 62946
Phone (618) 252-1109

20 Dr Warren Tuttle Dr
Harrisburg, IL 62946
Phone (618) 942-7300

201 S 14th St
Herrin, IL 62948
Phone (618) 942-2171

3309 Logan Dr
Herrin, IL 62948
Phone (618) 549-1882

400 Lincoln Dr
Herrin, IL 62948
Phone (270) 443-6472

5 West Frankfort Plz
West Frankfort, IL 62896
Phone (618) 932-2643

502 W Saint Louis St
West Frankfort, IL 62896
Phone (618) 937-3400

Interoperability endpoints

  • Direct secure messaging: cholmes13505@sih.direct-ci.com
  • Direct secure messaging: cholme25@yourcarecommunity.org

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1515456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1508373770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W JACKSON ST STE 301",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011474",
            "telephone_number": "618-529-0520",
            "fax_number": "618-529-0519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "CHRISTY",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-09",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "277002112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cholmes13505@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "305 W Jackson St Ste 301",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.