Jacqueline Priscillia Holmes

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

136394 Issued in FL

Practice address

5834 Aruba Way
West Palm BCH, FL 33407-1708

Phone

(904) 554-0628

NPI assigned

Jul 29, 2013

Last updated

Feb 19, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 123 Butterfly Effects L.L.C

  dba Jacqueline Holmes

  • Nurse's Aide
  • Jacksonville, FL
  • NPI 1124610092
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392768000000",
    "number": "1790127967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5834 ARUBA WAY",
            "city": "WEST PALM BCH",
            "state": "FL",
            "postal_code": "334071708",
            "telephone_number": "904-554-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5834 ARUBA WAY",
            "city": "WEST PALM BCH",
            "state": "FL",
            "postal_code": "334071708",
            "telephone_number": "904-554-0628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "JACQUELINE",
        "middle_name": "PRISCILLIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-29",
        "last_updated": "2014-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "FL",
            "license": "136394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse's Aide in West Palm BCH, FL
• Providers in West Palm BCH, FL by specialty
• Nurse's Aide in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; 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.