Lori Rae Holtzman, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

31899 Issued in TN

Practice address

2565 Horizon Lake Dr Ste 114
Memphis, TN 38133-8113

Phone

(901) 350-2639

Fax

(901) 249-4563

NPI assigned

Jul 27, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17965/brand/1/csg/1/fhir/r4
• Direct secure messaging: lori.holtzman.1@17965.direct.athenahealth.com

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.

• Cody'S Center of Hope, Dedicated Pediatric Care, PC

  • Pediatrics Physician
  • Memphis, TN
  • NPI 1740778166
  Medicare reassignment NPD Authorized official
• Baptist Memorial Medical Group Inc

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1306089206

  Pediatrics

  NPD
• Pediatric Emergency Specialists, PC

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Memphis, TN
  • NPI 1760482434
  NPD (past)

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1023018587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 381442",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381831442",
            "telephone_number": "901-350-2639",
            "fax_number": "901-249-4563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2565 HORIZON LAKE DR STE 114",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381338113",
            "telephone_number": "901-350-2639",
            "fax_number": "901-249-4563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTZMAN",
        "first_name": "LORI",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-27",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "TN",
            "license": "31899",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "TNMD31899",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "31899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00121309",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3496002",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Holtgrewe, LPC-MHSP (TEMP)
• Rose M Marie Holton, M.D.
• Sara N Holton
• Shannon Holtrop, CGC, LGC
• McKasher Lashawn Holts, RN
• Melinda Homa
• Saundra Gail Homan, FNP
• Home at Heart Group Living, Inc
• Home Care Management Nursing Agency LLC
• Home Care Medical Systems Inc

• Pediatrics Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.