Jillian Kate Holsonback, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT013371 Issued in GA

Practice address

304 Emory St
Valdosta, GA 31602

Phone

(229) 244-1667

Fax

(229) 244-8253

NPI assigned

Jul 11, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jillian Kate Salas Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Choice Family Medicine, PC

  • Primary Care Clinic/Center
  • Valdosta, GA
  • NPI 1609087469

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1278806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1114239779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 EMORY ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021808",
            "telephone_number": "229-244-1667",
            "fax_number": "229-244-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 EMORY ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31602",
            "telephone_number": "229-244-1667",
            "fax_number": "229-244-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLSONBACK",
        "first_name": "JILLIAN",
        "middle_name": "KATE",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-11",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "15271",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT013371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLIAN",
            "last_name": "SALAS",
            "middle_name": "KATE",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley Holliday
• Diane Carol Holliman, PHD, LCSW
• Tamia Hollis
• Rachael Shingler Holloman, LPC
• Melinda Holmes
• Joseph Edward Holt, RPH
• Bay Holton, CCC-SLP
• Gresham Royal Holton, PH.D.,LMFT
• Kasey S Holyfield
• Homewell Care Services Ga-349

• Physical Therapist in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.

Verify at the official NPI Registry.