Individual provider Active NPI

Nancy Elizabeth Holmes, M.D.

  • Pediatric Adolescent Medicine Physician
  • St. Louis, MO
National Provider Identifier
1740209162
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
MOR8702 Issued in MO
Practice address
8888 Ladue Road
Suite 130
St. Louis, MO 63124
Phone
(314) 862-4002
Fax
(314) 862-4008
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X MOR8702 MO Primary

Addresses

Primary practice location

8888 Ladue Road
Suite 130
St. Louis, MO 63124

Mailing address

7114 Waterman Ave
Saint Louis, MO 63130-4325
Phone (314) 862-4746

Other identifiers 1

IdentifierTypeStateIssuer
35787MedicaidMO

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MOR8702MOMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatric Associates LLC 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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740209162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7114 WATERMAN AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631304325",
            "telephone_number": "314-862-4746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8888 LADUE ROAD",
            "address_2": "SUITE 130",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63124",
            "telephone_number": "314-862-4002",
            "fax_number": "314-862-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "NANCY",
        "middle_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MO",
            "license": "MOR8702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35787",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.