Active NPI
Gregory Holmes
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Baldwinsville, NY
National Provider Identifier
1841578440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 060376
- Practice address
- 3588 State Route 31
Baldwinsville, NY 13027-8232 - Phone
- (315) 715-6030
- NPI assigned
- Jul 30, 2011
- Last updated
- Apr 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202209329 | VA | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 060376 | NY | Primary |
Addresses
Primary practice location
3588 State Route 31
Baldwinsville, NY 13027-8232
Mailing address
3167 Samantha Dr
Baldwinsville, NY 13027-8979
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202209329 | VA | MD | Pharmacist |
| 060376 | NY | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Rite Aid of Virginia Inc | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Rite Aid of Virginia Inc | Past | Accepting new patients |
Locations
3588 State Route 31
Baldwinsville, NY 13027
Phone (315) 715-6030
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Rite Aid Pharmacy 04789
- Community/Retail Pharmacy
- Virginia Beach, VA
- NPI 1205947413
-
dba Rite Aid Pharmacy 07520
- Community/Retail Pharmacy
- Grottoes, VA
- NPI 1982319000
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650499200000",
"number": "1841578440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3167 SAMANTHA DR",
"city": "BALDWINSVILLE",
"state": "NY",
"postal_code": "130278979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3588 STATE ROUTE 31",
"city": "BALDWINSVILLE",
"state": "NY",
"postal_code": "130278232",
"telephone_number": "315-715-6030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMES",
"first_name": "GREGORY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-30",
"last_updated": "2022-04-21",
"certification_date": "2022-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202209329",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "NY",
"license": "060376",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baldwinsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.