Tyler James Holloway, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT-2206 Issued in ID

Practice address

16171 N Brinson St
Nampa, ID 83687-5509

Phone

(208) 442-2525

NPI assigned

Sep 9, 2020

Last updated

Sep 9, 2020By the provider in NPPES

Sex

Male

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 ID

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Current Physical Therapy LLC

  • Physical Therapist
  • Fruitland, ID
  • NPI 1518478734
  Medicare reassignment NPD
• Idaho Therapy Source

  • Occupational Therapist
  • Nampa, ID
  • NPI 1235461732
  NPD (past)

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1053926816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16171 N BRINSON ST",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836875509",
            "telephone_number": "208-442-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16171 N BRINSON ST",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836875509",
            "telephone_number": "208-442-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "TYLER",
        "middle_name": "JAMES",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-09",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "ID",
            "license": "OT-2206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie Hoewing, NP
• Kathy Lynn Hohenbrink, R.D,,L.D.,DC.D.E.
• Shauni Holcomb, M.S., CF-SLP
• Holistic Healthcare LLC.
• Keith G Holley, MD
• Holly Lane Rehabilitation and Healthcare Center, LLC
• Sydney K Holmes, DO
• Wendi Holmes, CNM
• Rebecca Lynn Holmstead, LM, CPM
• Bradley Warren Holt, MSW, LMSW

• Pediatric Occupational Therapist in Nampa, ID
• Providers in Nampa, ID by specialty
• Pediatric Occupational Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.