Active NPI
Scott Holmes, D.O.
- Family Medicine Physician
- Petaluma, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20A17517
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150713002246 | DE | Order and Referring Only - Pediatric Medicine | 6709199227 | |
| I20251105003939 | CA | Order and Referring Only - Pediatric Medicine | 6709199227 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A17517 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New 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
- 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.
-
- Federally Qualified Health Center (FQHC)
- Petaluma, CA
- NPI 1588656268
-
- Federally Qualified Health Center (FQHC)
- Rohnert Park, CA
- NPI 1669870739
-
- Family Medicine Physician
- Brea, CA
- NPI 1871607762
-
- Skilled Nursing Facility
- Petaluma, CA
- NPI 1770703886
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.