Individual provider Active NPI

Carly Holloway

  • Physical Therapist
  • Flowood, MS
National Provider Identifier
1154049096
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7416 Issued in MS
Practice address
104 Burney Dr
Flowood, MS 39232-6621
Phone
(601) 987-8202
Fax
(601) 718-0293
NPI assigned
Aug 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7416 MS Primary

Addresses

Primary practice location

104 Burney Dr
Flowood, MS 39232-6621

Mailing address

PO Box 30594
Charlotte, NC 28230-0594
Phone (601) 987-8200

Other identifiers 1

IdentifierTypeStateIssuer
200006273MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230821002721 MS Practitioner - Physical Therapist in Private Practice 4486010535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Orthopaedic Clinic, PLLCGroup PAC ID 0941215255, 49 clinicians

Practice addresses (Care Compare)

953 Hwy 51
Madison, MS 39110-6007
Phone (769) 867-8270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7416MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Orthopaedic Clinic PLLC CurrentSince Dec 16, 2024 Accepting new patients
Capital Orthopaedic Clinic, PLLC CurrentSince Dec 16, 2024 Accepting new patients
Gptrs II Physical Therapist CurrentSince May 9, 2023 Accepting new patients
Genesis Physical Therapy & Rehabilitation LLC Physical Therapist PastSince Aug 1, 2022 Accepting new patients
Capital Orthopedic Clinic PLLC Past Accepting new patients

Locations

104 Burney Dr
Flowood, MS 39232
Phone (601) 987-8202

106 Highland Way
Ste 102
Madison, MS 39110

953 Highway 51
Madison, MS 39110
Phone (769) 867-8270

314 Airport Rd S
Pearl, MS 39208
Phone (601) 664-2044

227 Highway 51
Ridgeland, MS 39157
Phone (601) 898-4324

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1660694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1154049096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30594",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282300594",
            "telephone_number": "601-987-8200",
            "fax_number": "601-987-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 BURNEY DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392326621",
            "telephone_number": "601-987-8202",
            "fax_number": "601-718-0293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "CARLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-17",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "7416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200006273",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.