NPIMap

Individual provider Active NPI

Jeremy K Holmes, DO

  • Family Medicine Physician
  • Kalkaska, MI
National Provider Identifier
1912935867
Registry record updated Dec 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101013399 Issued in MI
Practice address
419 S Coral St
Kalkaska, MI 49646-2500
Phone
(231) 258-7777
NPI assigned
Jun 29, 2006
Last updated
Dec 21, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2020

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 5101013399 MI Primary

Addresses

Primary practice location

419 S Coral St
Kalkaska, MI 49646-2500

Mailing address

419 S Coral St
Kalkaska, MI 49646-2500
Phone (231) 258-7777

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jholmes@direct.mhc.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100813000183 MI Practitioner - Family Practice 8820122880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kalkaska Memorial Health CenterGroup PAC ID 3577536002, 57 clinicians

Practice addresses (Care Compare)

419 S Coral St
Kalkaska, MI 49646-2503
Phone (231) 258-7500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kalkaska Memorial Health Center Family Medicine Current Accepting new patients
Kalkaska Memorial Health Center CurrentSince Sep 8, 2003 Accepting new patients
Kalkaska Memorial Health Center Family Medicine CurrentSince Sep 8, 2003 Accepting new patients
Kalkaska Memorial Health Center Family Medicine Past Accepting new patients
Community Memorial Hospital Past Accepting new patients
Community Memorial Hospital Past Accepting new patients

Locations

419 S Coral St
Kalkaska, MI 49646
Phone (231) 258-7500

Interoperability endpoints

  • Direct secure messaging: jholmes@direct.mhc.net

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1912935867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 S CORAL ST",
            "city": "KALKASKA",
            "state": "MI",
            "postal_code": "496462500",
            "telephone_number": "231-258-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 S CORAL ST",
            "city": "KALKASKA",
            "state": "MI",
            "postal_code": "496462500",
            "telephone_number": "231-258-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "JEREMY",
        "middle_name": "K",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101013399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jholmes@direct.mhc.net",
            "affiliation": "N",
            "address_1": "419 S Coral St",
            "city": "Kalkaska",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496462500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalkaska, MI

Sources for this page

Verify at the official NPI Registry.