Individual provider Active NPI

Edward H Holmes, M.D.

  • Pulmonary Disease Physician
  • Meridian, MS
National Provider Identifier
1962408302
Registry record updated Apr 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
07673 Issued in MS
Practice address
2024 15TH St FL 2
Meridian, MS 39301-4130
Phone
(601) 553-2000
Fax
(601) 483-9471
NPI assigned
Jun 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 07673 MS Primary

Addresses

Primary practice location

2024 15TH St FL 2
Meridian, MS 39301-4130

Mailing address

2024 15TH St FL 2
Meridian, MS 39301-4130
Phone (601) 553-2000

Other identifiers 1

IdentifierTypeStateIssuer
00123662MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050523001041 MS Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 7214924547 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
07673MSMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Medical Associates, PA Pulmonary Disease CurrentSince Apr 30, 2004 Accepting new patients
Meridian Hma LLC Past Accepting new patients
Meridian Hma LLC Past Accepting new patients

Locations

2024 15th St
Fl 2
Meridian, MS 39301
Phone (601) 553-2000

1102 Constitution Ave
#F
Meridian, MS 39301
Phone (601) 693-2511

2124 14th St
Meridian, MS 39301
Phone (601) 483-8811

1102 Constitution Ave
Meridian, MS 39301
Phone (601) 693-2511

1102 Constitution Ave
Fl 2
Meridian, MS 39301
Phone (601) 484-7900

Organizations & group practices 3

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": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365465600000",
    "number": "1962408302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 15TH ST FL 2",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014130",
            "telephone_number": "601-553-2000",
            "fax_number": "601-483-9471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 15TH ST FL 2",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014130",
            "telephone_number": "601-553-2000",
            "fax_number": "601-483-9471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "EDWARD",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2013-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MS",
            "license": "07673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00123662",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.