Active NPI
Sandra Jean Hollowell, MSPT
- Physical Therapist
- Beverly Hills, CA
National Provider Identifier
1124178686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT294593
- Practice address
- 435 N Bedford Dr Ste 102
Beverly Hills, CA 90210-4319 - Phone
- (310) 385-9064
- NPI assigned
- Jan 10, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 05004055A | IN | |
| Physical Therapist | 225100000X | PT294593 | CA | Primary |
Addresses
Primary practice location
435 N Bedford Dr Ste 102
Beverly Hills, CA 90210-4319
Mailing address
147 S Gretna Green Way
Los Angeles, CA 90049-4015
Phone (574) 329-1781
Other practice location 1
1628 W Beardsley Ave
Elkhart, IN 46514-1881
Phone (574) 293-9420
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 |
|---|---|---|---|
| PT294593 | CA | MD | Physical Therapist |
| 05004055A | IN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KRNS Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapy Clinic/Center
- Elkhart, IN
- NPI 1700973914
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527120000000",
"number": "1124178686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 S GRETNA GREEN WAY",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900494015",
"telephone_number": "574-329-1781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "435 N BEDFORD DR STE 102",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902104319",
"telephone_number": "310-385-9064"
}
],
"practiceLocations": [
{
"address_1": "1628 W Beardsley Ave",
"address_purpose": "LOCATION",
"city": "Elkhart",
"state": "IN",
"postal_code": "465141881",
"country_code": "US",
"telephone_number": "574-293-9420",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOLLOWELL",
"first_name": "SANDRA",
"middle_name": "JEAN",
"credential": "MSPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-10",
"last_updated": "2018-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05004055A",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT294593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beverly Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.