Active NPI
Diane Holladay, OTR
- Occupational Therapist
- Venice, FL
National Provider Identifier
1184180648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 20037
- Practice address
- 417 Commercial CT Ste C
Venice, FL 34292-1655 - Phone
- (941) 485-0121
- NPI assigned
- Feb 20, 2019
- Last updated
- Jul 30, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 31006806A | IN | |
| Occupational Therapist | 225X00000X | 20037 | FL | Primary |
Addresses
Primary practice location
417 Commercial CT Ste C
Venice, FL 34292-1655
Mailing address
15722 Ibisridge Dr
Lithia, FL 33547-3893
Phone (317) 509-4940
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 |
|---|---|---|---|
| 20037 | FL | MD | Occupational Therapist |
| 31006806A | IN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596067200000",
"number": "1184180648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15722 IBISRIDGE DR",
"city": "LITHIA",
"state": "FL",
"postal_code": "335473893",
"telephone_number": "317-509-4940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 COMMERCIAL CT STE C",
"city": "VENICE",
"state": "FL",
"postal_code": "342921655",
"telephone_number": "941-485-0121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLADAY",
"first_name": "DIANE",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-20",
"last_updated": "2020-07-30",
"certification_date": "2020-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31006806A",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "20037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Venice, FL
- Raul Holguin, M.D.
- Holiday CVS LLC (CVS Pharmacy# 01120)
- Holiday CVS LLC (CVS Pharmacy #04266)
- Holiday CVS LLC (CVS Pharmacy 03647)
- Holiday CVS LLC (CVS Pharmacy #16261)
- Erik Stefan Holsen, DMD
- Home Care X-Ray Services Inc (Gpsi Mobile Digital Imaging)
- Home Detox Inc
- Madison Elizabeth Hook, DMD
- Hope Counseling of Venice, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.