Individual provider Active NPI

Michael P Holliday, PT

  • Specialist
  • Philippi, WV
National Provider Identifier
1215052188
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1343 Issued in WV
Practice address
RT 2 Box 120F
Philippi, WV 26416
Phone
(304) 457-1757
Fax
(304) 457-1757
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1343 WV Primary

Addresses

Primary practice location

RT 2 Box 120F
Philippi, WV 26416

Mailing address

RT 2 Box 120F
Philippi, WV 26416
Phone (304) 457-1757

Other identifiers 1

IdentifierTypeStateIssuer
0157575000MedicaidWV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080811000119 WV Practitioner - Physical Therapist in Private Practice 2961576871 Reassigns benefits to 1 organization
Practice locations: Philippi, WV

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Corridor H Physical Therapy LLCGroup PAC ID 5799298022, 2 clinicians

Practice addresses (Care Compare)

1600 Stalnaker Rd
Philippi, WV 26416-7617

4 Right Saw Mill Rd
Horner, WV 26372-9743
Phone (304) 997-4041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1343WVMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Corridor H Physical Therapy LLC CurrentSince Apr 19, 2025 Accepting new patients

Locations

4 Right Saw Mill Rd
Horner, WV 26372
Phone (304) 997-4041

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1215052188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RT 2 BOX 120F",
            "city": "PHILIPPI",
            "state": "WV",
            "postal_code": "26416",
            "telephone_number": "304-457-1757",
            "fax_number": "304-457-1757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RT 2 BOX 120F",
            "city": "PHILIPPI",
            "state": "WV",
            "postal_code": "26416",
            "telephone_number": "304-457-1757",
            "fax_number": "304-457-1757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIDAY",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WV",
            "license": "1343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0157575000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philippi, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.