Crystal Gayle Hollatz, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2975 Issued in NE

Practice address

5401 South St
Lincoln, NE 68506-2150

Phone

(402) 489-7102

Fax

(402) 486-9098

NPI assigned

Jul 13, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

William H and Carrie Gottsche FoundationGroup PAC ID 5092606293, 73 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• William H and Carrie Gottsche Foundation

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Thermopolis, WY
  • NPI 1558319392
  Medicare reassignment Care Compare group
• Holistic Pain Management of Wyoming, LLC

  • Family Nurse Practitioner
  • Riverton, WY
  • NPI 1487295846
  NPD (past)

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310515200000",
    "number": "1013205913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 SOUTH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062150",
            "telephone_number": "402-489-7102",
            "fax_number": "402-486-9098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 SOUTH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062150",
            "telephone_number": "402-489-7102",
            "fax_number": "402-486-9098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLATZ",
        "first_name": "CRYSTAL",
        "middle_name": "GAYLE",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2011-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "2975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rolf Holbrook
• Sirenity Holden
• Tori Nicole Holgate
• Holistic Harmony Inc.
• Holistic Healing Counseling Center, LLC
• Adam Scott Holle
• Holly Holle
• Jillian Holle
• Jed Earl Hollenbeck, PA-C
• Kirsten Hollenbeck, CRNA

• Physical Therapist in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Physical Therapist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.