Individual provider Active NPI

Heather Ann Holmes, PA-C

  • Physician Assistant
  • Northbrook, IL
National Provider Identifier
1750904462
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0008421 Issued in CO
Practice address
333 Skokie Blvd Ste 108
Northbrook, IL 60062-1623
Phone
(847) 450-6393
Fax
(847) 919-8375
NPI assigned
May 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0008421 CO Primary

Addresses

Primary practice location

333 Skokie Blvd Ste 108
Northbrook, IL 60062-1623

Mailing address

333 Skokie Blvd Ste 108
Northbrook, IL 60062-1623
Phone (847) 450-6393

Other practice location 1

10535 Park Meadows Blvd Ste 200
Lone Tree, CO 80124-8457
Phone (303) 228-8958

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, CO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211018001820 IL Practitioner - Physician Assistant 4284032541 Reassigns benefits to 3 organizations
I20240516001557 CO Practitioner - Physician Assistant 4284032541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Musec Medical LLCGroup PAC ID 4385997931, 4 clinicians

Practice addresses (Care Compare)

1520 W Walton St
Apt 3
Chicago, IL 60642-5523
Phone (312) 823-5886

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center, LLC CurrentSince Apr 8, 2024 Accepting new patients
Family Care Center, LLC Physician Assistant CurrentSince Apr 8, 2024 Accepting new patients
Clarity Clinic Arlington Heights, LLC PastSince Jun 20, 2022 Accepting new patients
Illinois Post-Acute Medical Services 1 PC Past Accepting new patients

Locations

2860 S Circle Dr
Ste 109
Colorado Springs, CO 80906
Phone 71954021004002

10535 Park Meadows Blvd
Lone Tree, CO 80124
Phone (303) 662-8250

10535 Park Meadows Blvd
Ste 200
Lone Tree, CO 80124
Phone (303) 228-8958

Organizations & group practices 7

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": "1590624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1750904462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 SKOKIE BLVD STE 108",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621623",
            "telephone_number": "847-450-6393",
            "fax_number": "847-919-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SKOKIE BLVD STE 108",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621623",
            "telephone_number": "847-450-6393",
            "fax_number": "847-919-8375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10535 Park Meadows Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Lone Tree",
            "state": "CO",
            "postal_code": "801248457",
            "country_code": "US",
            "telephone_number": "303-228-8958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "HEATHER",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-28",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0008421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.