Active NPI
Brandy Dawn Holmquist, COTA
- Occupational Therapy Assistant
- Logansport, IN
National Provider Identifier
1174749527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 32000817A
- Practice address
- 1603 Case Road
Logansport, IN 46947 - Phone
- (574) 737-7404
- NPI assigned
- Apr 17, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 32000817A | IN | Primary |
Addresses
Primary practice location
1603 Case Road
Logansport, IN 46947
Mailing address
3125 East 900 South
Walton, IN 46994
Phone (574) 753-1707
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32000817A | IN | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174749527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3125 EAST 900 SOUTH",
"city": "WALTON",
"state": "IN",
"postal_code": "46994",
"telephone_number": "574-753-1707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1603 CASE ROAD",
"city": "LOGANSPORT",
"state": "IN",
"postal_code": "46947",
"telephone_number": "574-737-7404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMQUIST",
"first_name": "BRANDY",
"middle_name": "DAWN",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IN",
"license": "32000817A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Logansport, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.