Physician Compare National (NPI:1942297858)

HEALTHCARE PROVIDER: KEVIN H HOLMES M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1942297858
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0244248094
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20060411000265
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HOLMES
	Individual professional last name
Provider First Name	KEVIN
	Individual professional first name
Provider Middle Name	H
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	THE MARION COUNTY INTERNAL MEDICINE CLINIC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	1153330618
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	104 PARTNERSHIP WAY
	Group Practice or individual's line 1 address
City	COLUMBIA
	Group Practice or individual's city
State	MS
	Group Practice or individual's state
Zip Code	394294502
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6017366443
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	250085
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MARION GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	251324
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	WALTHALL COUNTY GENERAL HOSPITAL CAH
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	251326
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	JEFFERSON DAVIS GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y