Individual provider Active NPI

Kelly Steven Holman, PT, MS

  • Physical Therapist
  • Scottsville, KY
National Provider Identifier
1215979489
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-003727 Issued in KY
Practice address
208 S Court St
Scottsville, KY 42164-1263
Phone
(270) 239-6640
Fax
(270) 239-6674
NPI assigned
Jun 12, 2006
Last updated
Dec 4, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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 PT-003727 KY Primary

Addresses

Primary practice location

208 S Court St
Scottsville, KY 42164-1263

Mailing address

PO Box 51246
Bowling Green, KY 42102-5546
Phone (270) 726-6640

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PT-003727KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedics Plus Physical Therapy Past Accepting new patients
Commonwealth Health Corporation, Inc. Past Accepting new patients
Commonwealth Health Corporation Past Accepting new patients

Organizations & group practices 3

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1215979489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51246",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421025546",
            "telephone_number": "270-726-6640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 S COURT ST",
            "city": "SCOTTSVILLE",
            "state": "KY",
            "postal_code": "421641263",
            "telephone_number": "270-239-6640",
            "fax_number": "270-239-6674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMAN",
        "first_name": "KELLY",
        "middle_name": "STEVEN",
        "name_prefix": "Mr.",
        "credential": "PT, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "PT-003727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.

Verify at the official NPI Registry.