Active NPI
Cody John Holmes, CSW
- Clinical Social Worker
- Bountiful, UT
National Provider Identifier
1669958468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 10859961-3502
- Practice address
- 1459 N Main St
Bountiful, UT 84010-6092 - Phone
- (801) 298-2000
- NPI assigned
- Jul 14, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 10859961-3502 | UT | Primary |
Addresses
Primary practice location
1459 N Main St
Bountiful, UT 84010-6092
Mailing address
288 W 160 N
Clearfield, UT 84015-3201
Phone (385) 333-8456
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 15, 2026 through May 15, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10859961-3502 | UT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531526400000",
"number": "1669958468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "288 W 160 N",
"city": "CLEARFIELD",
"state": "UT",
"postal_code": "840153201",
"telephone_number": "385-333-8456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1459 N MAIN ST",
"city": "BOUNTIFUL",
"state": "UT",
"postal_code": "840106092",
"telephone_number": "801-298-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMES",
"first_name": "CODY",
"middle_name": "JOHN",
"credential": "CSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-14",
"last_updated": "2018-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "10859961-3502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bountiful, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.