Active NPI
Brenda Kay Holzer, CFM
- Mastectomy Fitter
- Conyers, GA
National Provider Identifier
1053852343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mastectomy Fitter
- Practice address
- 2141 Eastview Pkwy
Conyers, GA 30013-5756 - Phone
- (770) 922-5540
- Fax
- (770) 922-8535
- NPI assigned
- Mar 20, 2017
- Last updated
- Mar 20, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mastectomy Fitter | 224900000X | NU | Primary |
Addresses
Primary practice location
2141 Eastview Pkwy
Conyers, GA 30013-5756
Mailing address
2141 Eastview Pkwy
Conyers, GA 30013-5756
Phone (770) 922-5540
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0008128253A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Able Prosthetic Care, Inc. | Current | Accepting new patients | |
| Able Prosthetic Care, Inc. | Current | Accepting new patients |
Locations
2141 Eastview Pkwy
Conyers, GA 30013
Phone (770) 922-5540
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Prosthetist
- Conyers, GA
- NPI 1063481505
-
- Prosthetic/Orthotic Supplier
- Madison, GA
- NPI 1528296498
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489968000000",
"number": "1053852343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2141 EASTVIEW PKWY",
"city": "CONYERS",
"state": "GA",
"postal_code": "300135756",
"telephone_number": "770-922-5540",
"fax_number": "770-922-8535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2141 EASTVIEW PKWY",
"city": "CONYERS",
"state": "GA",
"postal_code": "300135756",
"telephone_number": "770-922-5540",
"fax_number": "770-922-8535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLZER",
"first_name": "BRENDA",
"middle_name": "KAY",
"name_prefix": "Mrs.",
"credential": "CFM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-20",
"last_updated": "2017-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "224900000X",
"taxonomy_group": "",
"desc": "Mastectomy Fitter",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0008128253A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Conyers, GA
- Geraldo Enrique Holguin Terrero, MD
- Holistic Counseling and Wellness Center LLC
- Holistic Health Management, LLC (Multi-Care Holistic Health Center)
- Kenika Holloway
- Kenyata B Holton, DPT
- Daniel T. Holzer, CP, LP
- Home Guard Private Home Care LLC (My Home Guard Care LLC)
- Home of the Heroes
- Honey Creek Dental
- Honeycreek Dental
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.