Individual provider Active NPI

Gina Doreen Holmes, PA

  • Medical Physician Assistant
  • Napa, CA
National Provider Identifier
1548260227
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA21749 Issued in CA
Practice address
3419 Valle Verde Dr
Napa, CA 94558-2414
Phone
(888) 244-6493
Fax
(707) 226-3143
NPI assigned
Jul 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA07912 TX
Medical Physician Assistant 363AM0700X PA21749 CA Primary
Medical Physician Assistant 363AM0700X 1173023 WI

Addresses

Primary practice location

3419 Valle Verde Dr
Napa, CA 94558-2414

Mailing address

3419 Valle Verde Dr
Napa, CA 94558-2414
Phone (888) 244-6493

Other practice location 1

925 Corporate Cntr Pkwy Ste A
Santa Rosa, CA 95407-5453
Phone (707) 543-2000

Other names 1

  • Gina Doreen Knudsen Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address urgentcareqvmc@sjhhandhmg.allscriptsdirect.net
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20111003000078 CA Practitioner - Physician Assistant 0648249870 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1621 W Imola Ave
Napa, CA 94559-4721
Phone (707) 251-4280

200 W Ctr St Promenade
Anaheim, CA 92805-3960

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
21749CAMDPediatrics Physician
1173WIMDPodiatrist
PA21749CAMDMedical Physician Assistant
PA07912TXMDMedical Physician Assistant
1173023WIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northbay Healthcare Group CurrentSince Dec 1, 2019 Accepting new patients
Northbay Health Medical Foundation CurrentSince Feb 14, 2026 Accepting new patients
Providence Medical Foundation CurrentSince Jun 15, 2016 Accepting new patients
Providence Medical Foundation CurrentSince Jun 15, 2016 Accepting new patients
Golden State Dermatology Associates, Inc. CurrentSince Jul 12, 2022 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Providence Medical Foundation Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients

Locations

416 Napa Junction Rd
#140
American Canyon, CA 94503

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

1000 Trancas St
Napa, CA 94558
Phone (707) 226-2901

1100 Trancas St
Ste 209
Napa, CA 94558
Phone (707) 251-1850

1621 W Imola Ave
Napa, CA 94559
Phone (707) 251-4280

1450 Medical Center Dr
Rohnert Park, CA 94928
Phone (707) 546-3210

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

925 Corporate Cntr Pkwy
Ste A
Santa Rosa, CA 95407
Phone (707) 543-2000

1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000

355 Lennon Ln
Ste 255
Walnut Creek, CA 94598
Phone (925) 932-7704

370 N Wiget Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 278-7592

6580 Hembree Ln
Ste 270
Windsor, CA 95492
Phone (707) 838-2044

101 Main St
Winters, CA 95694
Phone (530) 795-4123

Interoperability endpoints

  • Direct secure messaging: gknudsen1648031@oc.providencedirect.org

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1548260227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419 VALLE VERDE DR",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945582414",
            "telephone_number": "888-244-6493",
            "fax_number": "707-226-3143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 VALLE VERDE DR",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945582414",
            "telephone_number": "888-244-6493",
            "fax_number": "707-226-3143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 Corporate Cntr Pkwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954075453",
            "country_code": "US",
            "telephone_number": "707-543-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "GINA",
        "middle_name": "DOREEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA07912",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA21749",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "1173023",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "urgentcareqvmc@sjhhandhmg.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "925 Corporate Cntr Pkwy Ste A",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954075453",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "401 Bicentennial Way",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954032149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "KNUDSEN",
            "middle_name": "DOREEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Napa, CA

Sources for this page

Verify at the official NPI Registry.