Individual provider Active NPI

Johnathon Holmes

  • Nurse Practitioner
  • Chestnut Hill, MA
National Provider Identifier
1952064073
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2296537 Issued in MA
Practice address
25 Boylston St
Chestnut Hill, MA 02467-1715
Phone
(617) 916-0895
NPI assigned
Oct 15, 2021
Last updated
Oct 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2296537 MA Primary

Addresses

Primary practice location

25 Boylston St
Chestnut Hill, MA 02467-1715

Mailing address

64 Fletcher St # 1
Roslindale, MA 02131-1918
Phone (401) 595-7812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220115000084 MA Practitioner - Nurse Practitioner 0749671485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
David August MD LLCGroup PAC ID 4688818388, 2 clinicians

Practice addresses (Care Compare)

25 Boylston St
Suite 302
Chestnut Hill, MA 02467-1710
Phone (617) 916-0895

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2296537MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
David August MD, LLC CurrentSince Jan 12, 2022 Accepting new patients

Locations

25 Boylston St
Ste 302
Chestnut Hill, MA 02467
Phone (617) 916-0895

Organizations & group practices 1

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 1

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": "1634256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1952064073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 FLETCHER ST # 1",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021311918",
            "telephone_number": "401-595-7812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 BOYLSTON ST",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024671715",
            "telephone_number": "617-916-0895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "JOHNATHON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-15",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "2296537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chestnut Hill, MA

Sources for this page

Verify at the official NPI Registry.