Individual provider Active NPI

Christine Holmes

  • Behavior Technician
  • Lake Grove, NY
National Provider Identifier
1538610308
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
16 Frederick Ave
Lake Grove, NY 11755-3212
Phone
(631) 901-7331
NPI assigned
Oct 17, 2016
Last updated
Oct 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X NY Primary

Addresses

Primary practice location

16 Frederick Ave
Lake Grove, NY 11755-3212

Mailing address

16 Frederick Ave
Lake Grove, NY 11755-3212
Phone (631) 901-7331

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

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1538610308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 FREDERICK AVE",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117553212",
            "telephone_number": "631-901-7331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 FREDERICK AVE",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117553212",
            "telephone_number": "631-901-7331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "CHRISTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Grove, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.