Active NPI
Omar Holmes
- Massage Therapist
- Atlanta, GA
National Provider Identifier
1548874134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT002364
- Practice address
- 3312 Wheeler Dr
Atlanta, GA 30340-3236 - Phone
- (678) 437-7074
- NPI assigned
- Sep 1, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT002364 | GA | Primary |
Addresses
Primary practice location
3312 Wheeler Dr
Atlanta, GA 30340-3236
Mailing address
3312 Wheeler Dr
Atlanta, GA 30340-3236
Phone (678) 437-7074
Other practice location 1
3312 Wheeler Dr
Atlanta, GA 30340-3236
Phone (678) 437-7074 ext. 67843
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT002364 | GA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598918400000",
"number": "1548874134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3312 WHEELER DR",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303403236",
"telephone_number": "678-437-7074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3312 WHEELER DR",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303403236",
"telephone_number": "678-437-7074"
}
],
"practiceLocations": [
{
"address_1": "3312 Wheeler Dr",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303403236",
"country_code": "US",
"telephone_number": "678-437-7074 x67843",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOLMES",
"first_name": "OMAR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-09-01",
"last_updated": "2020-09-01",
"certification_date": "2020-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "GA",
"license": "MT002364",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.