Holly D Jordan, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3014 Issued in AZ

Practice address

2244 S Avenue a Ste E
Yuma, AZ 85364-8341

Phone

(928) 782-5588

Fax

(928) 782-5755

NPI assigned

Jan 25, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Holly D Sullivan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Elite Physical Therapy and Pilates Rehabilitation PC

  • Physical Therapy Clinic/Center
  • Yuma, AZ
  • NPI 1659792836

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1516838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516838400000",
    "number": "1225536105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2244 S AVENUE A STE E",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853648341",
            "telephone_number": "928-782-5588",
            "fax_number": "928-782-5755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2244 S AVENUE A STE E",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853648341",
            "telephone_number": "928-782-5588",
            "fax_number": "928-782-5755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "HOLLY",
        "middle_name": "D",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-25",
        "last_updated": "2018-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "3014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "SULLIVAN",
            "middle_name": "D",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rhonda Johnson, FOSTER PARENT
• David Johnston
• Frederic Clinton Jones, RPH
• Michael Gabriel Jones, PA-C
• Shelita Jones, NP
• Mark Jordan, PHARM.D.
• Joseph D. Gallemore DDS & Associates P.C.
• Julie Dance PLLC
• Julio Zonis, MD PC
• Juniper Tree Academy

• Occupational Therapist in Yuma, AZ
• Providers in Yuma, AZ by specialty
• Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; 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.