Individual provider Active NPI

Corrie Elizabeth Holmes, AU.D.

  • Audiologist
  • Pocatello, ID
National Provider Identifier
1548548589
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AUD-2521 Issued in ID
Practice address
650 Memorial Drive Building 68
Pocatello, ID 83209
Phone
(208) 282-3495
Fax
(208) 282-4571
NPI assigned
Jul 25, 2011
Last updated
Jun 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AUD-2521 ID Primary

Addresses

Primary practice location

650 Memorial Drive Building 68
Pocatello, ID 83209

Mailing address

921 S 8TH Ave Stop 8116
Pocatello, ID 83209-0001
Phone (208) 282-3495

Other practice location 1

805 Main St
Salmon, ID 83467-4316
Phone (208) 282-3495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140902002211 ID Practitioner - Qualified Audiologist 5890913958 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pocatello Health Services LLCGroup PAC ID 6608927637, 171 clinicians

Practice addresses (Care Compare)

777 Hospital Way
Pocatello, ID 83201-5175
Phone (208) 239-2260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AUD-2521IDMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Idaho State University CurrentSince Sep 1, 2014 Accepting new patients
Pocatello Health Services, LLC CurrentSince Aug 26, 2024 Accepting new patients
Pocatello Health Services, LLC CurrentSince Aug 26, 2024 Accepting new patients
Idaho State University CurrentSince Sep 1, 2014 Accepting new patients
Pocatello Health Services, LLC Current Accepting new patients
Pocatello Hospital LLC Current Accepting new patients
Idaho State University Audiologist Current Accepting new patients

Locations

1311 E Central Dr
Meridian, ID 83642
Phone (208) 373-1734

777 Hospital Way
Ste 202
Pocatello, ID 83201
Phone (208) 239-2640

777 Hospital Way
Ste G15
Pocatello, ID 83201
Phone (208) 239-2260

921 S 8th Ave
Stop 8116
Pocatello, ID 83209
Phone (208) 282-3495

805 Main St
Salmon, ID 83467
Phone (208) 282-3495

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1548548589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 S 8TH AVE STOP 8116",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832090001",
            "telephone_number": "208-282-3495",
            "fax_number": "208-282-4571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 MEMORIAL DRIVE BUILDING 68",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83209",
            "telephone_number": "208-282-3495",
            "fax_number": "208-282-4571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "805 Main St",
            "address_purpose": "LOCATION",
            "city": "Salmon",
            "state": "ID",
            "postal_code": "834674316",
            "country_code": "US",
            "telephone_number": "208-282-3495",
            "fax_number": "208-282-4571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "CORRIE",
        "middle_name": "ELIZABETH",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-25",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "ID",
            "license": "AUD-2521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.