Active NPI
Mary Holmes, MASTER'S
- Behavior Analyst
- West Des Moines, IA
National Provider Identifier
1669070751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 7755 Office Plaza Dr N Ste 105
West Des Moines, IA 50266-2339 - Phone
- (515) 505-7283
- NPI assigned
- Oct 12, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
7755 Office Plaza Dr N Ste 105
West Des Moines, IA 50266-2339
Mailing address
4506 NW 164TH St
Clive, IA 50325-2534
Phone (515) 223-3059
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KP Enterprises Iowa | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
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": "1602460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676332800000",
"number": "1669070751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4506 NW 164TH ST",
"city": "CLIVE",
"state": "IA",
"postal_code": "503252534",
"telephone_number": "515-223-3059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7755 OFFICE PLAZA DR N STE 105",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502662339",
"telephone_number": "515-505-7283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMES",
"first_name": "MARY",
"credential": "MASTER'S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-12",
"last_updated": "2023-02-14",
"certification_date": "2023-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.