Holly Jean Ray, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10648 Issued in WI

Practice address

1300 Egg Harbor Rd Ste 152
Sturgeon Bay, WI 54235-1248

Phone

(920) 746-0410

NPI assigned

Sep 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Holly Jean Miller Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1114018157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 S 18TH AVE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542351401",
            "telephone_number": "920-743-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 EGG HARBOR RD STE 152",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542351248",
            "telephone_number": "920-746-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "HOLLY",
        "middle_name": "JEAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "769-39",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36118100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "MILLER",
            "middle_name": "JEAN",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David A Rader, PT
• Hazel Radtke
• Ann M Rankin, OTR
• Katelyn Rankin, OTR
• Carl Arthur Rauch, RPH
• Wendi Marie Ray, MS, CCC-SLP
• Megan Marie Recupero, PHARMD
• Kelton J Reitz, D.O.
• Rejuvenate Life Chiropractic, LLC
• Ronie Partosa Remoto, PT

• Physical Therapist in Sturgeon Bay, WI
• Providers in Sturgeon Bay, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.