Individual provider Active NPI

Scott Holmes, D.O.

  • Family Medicine Physician
  • Petaluma, CA
National Provider Identifier
1801281027
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A17517 Issued in CA
Practice address
1179 N McDowell Blvd
Petaluma, CA 94954
Phone
(707) 559-7500
Fax
(707) 559-7620
NPI assigned
Apr 3, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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 20A17517 CA Primary

Addresses

Primary practice location

1179 N McDowell Blvd
Petaluma, CA 94954

Mailing address

1179 N McDowell Blvd
Petaluma, CA 94954-6559
Phone (707) 559-7500

Other practice location 1

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 733-1042

Other practice location 2

8465 Old Redwood Hwy Ste 320
Windsor, CA 95492-9244
Phone (707) 432-1170

Other practice location 3

1381 University St
Healdsburg, CA 95448-3314
Phone (707) 433-5494

Other practice location 4

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 733-1042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150713002246 DE Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 6709199227
I20251105003939 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 6709199227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A17517CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Petaluma Health Center Inc Past Accepting new patients
Petaluma Health Center Inc Past Accepting new patients
SRM Alliance Hospital Services Past Accepting new patients
Providence Medical Foundation Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sholmes614186@direct.ochin.org

Organizations & group practices 4

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": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1801281027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1179 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546559",
            "telephone_number": "707-559-7500",
            "fax_number": "707-559-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1179 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94954",
            "telephone_number": "707-559-7500",
            "fax_number": "707-559-7620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4755 Ogletown Stanton Rd",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197182200",
            "country_code": "US",
            "telephone_number": "302-733-1042",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8465 Old Redwood Hwy Ste 320",
            "address_purpose": "LOCATION",
            "city": "Windsor",
            "state": "CA",
            "postal_code": "954929244",
            "country_code": "US",
            "telephone_number": "707-432-1170",
            "fax_number": "707-837-0129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1381 University St",
            "address_purpose": "LOCATION",
            "city": "Healdsburg",
            "state": "CA",
            "postal_code": "954483314",
            "country_code": "US",
            "telephone_number": "707-433-5494",
            "fax_number": "707-433-0229",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4755 Ogletown Stanton Rd",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197182200",
            "country_code": "US",
            "telephone_number": "302-733-1042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-03",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A17517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

Verify at the official NPI Registry.