Active NPI
Holly Weller, PT, DPT
- Physical Therapist
- Louisville, KY
National Provider Identifier
1104294545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05011824A
- Practice address
- 2701 Chestnut Station CT
Louisville, KY 40299 - Phone
- (800) 335-1060
- NPI assigned
- Sep 2, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT016064 | OH | |
| Physical Therapist | 225100000X | 05011824A | IN | Primary |
Addresses
Primary practice location
2701 Chestnut Station CT
Louisville, KY 40299
Mailing address
2901 N Andy Way
Bloomington, IN 47404-1327
Phone (765) 729-4367
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05011824A | IN | MD | Physical Therapist |
| PT016064 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534896000000",
"number": "1104294545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 N ANDY WAY",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474041327",
"telephone_number": "765-729-4367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 CHESTNUT STATION CT",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "40299",
"telephone_number": "800-335-1060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLER",
"first_name": "HOLLY",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-02",
"last_updated": "2018-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT016064",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05011824A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.