Provider Demographics
NPI:1497374060
Name:HOLMES, JAMES (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:HOLMES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FAMILY MEDICINE ,ETC
Mailing Address - Street 1:1951 PISGAH RD STE 104
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-6705
Mailing Address - Country:US
Mailing Address - Phone:184-362-1364
Mailing Address - Fax:843-413-3283
Practice Address - Street 1:525 N TRYON ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-0202
Practice Address - Country:US
Practice Address - Phone:843-621-3641
Practice Address - Fax:843-413-3283
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-13
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPG0668207Q00000X
SCM063207Q00000X
NCHC6461251E00000X, 253Z00000X
SCIHCP-0420251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCHC6461OtherNC DHHS
SCIHCP-0402OtherINSURANCE
SCPG0668Medicaid
SCEX0989Medicaid
SCIHCP-0402OtherSC DHHS
SCM063OtherFAMILY PRACTICE