Individual provider Active NPI

Michelle Holmes

  • Family Medicine Physician
  • Brentwood, CA
National Provider Identifier
1720145626
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A83960 Issued in CA
Practice address
171 Sand Creek Rd
Suite a
Brentwood, CA 94513-2033
Phone
(925) 513-6800
Fax
(925) 513-6874
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A83960 CA Primary

Addresses

Primary practice location

171 Sand Creek Rd
Suite a
Brentwood, CA 94513-2033

Mailing address

171 Sand Creek Rd
Suite a
Brentwood, CA 94513-2033
Phone (925) 513-6800

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060306000341 CA Practitioner - Family Practice 9638185234 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1720145626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 SAND CREEK RD",
            "address_2": "SUITE A",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945132033",
            "telephone_number": "925-513-6800",
            "fax_number": "925-513-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 SAND CREEK RD",
            "address_2": "SUITE A",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945132033",
            "telephone_number": "925-513-6800",
            "fax_number": "925-513-6874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A83960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, CA

Sources for this page

Verify at the official NPI Registry.