Individual provider Active NPI

Virginia Susan Holman, MPT

  • Physical Therapist
  • Woodburn, OR
National Provider Identifier
1245274158
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3455 Issued in OR
Practice address
1359 N Pacific Hwy
Woodburn, OR 97071
Phone
(503) 982-0232
Fax
(503) 873-6113
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2018

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 3455 OR Primary

Addresses

Primary practice location

1359 N Pacific Hwy
Woodburn, OR 97071

Mailing address

495 State St FL 6
Salem, OR 97301-3757

Other names 1

  • Ginger Susan Holman Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101021000667 OR Practitioner - Physical Therapist in Private Practice 2466645569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanders Hand Therapy, Inc.Group PAC ID 3971775941, 9 clinicians

Practice addresses (Care Compare)

8995 SW Miley Rd
Suite 109
Wilsonville, OR 97070-5485
Phone (503) 694-8366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3455ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Sanders Hand Therapy, Inc CurrentSince Mar 13, 2023 Accepting new patients
Capitol Physical & Hand Therapy II Physical Therapist Past Accepting new patients
Capitol Physical & Hand Therapy II Physical Therapist Past Accepting new patients

Locations

25030 SW Parkway Ave
Ste 104
Wilsonville, OR 97070
Phone (503) 694-8366

8995 SW Miley Rd
Ste 109
Wilsonville, OR 97070
Phone (503) 694-8134

2217 Country Club Rd
Woodburn, OR 97071
Phone (503) 318-3927

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1245274158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 STATE ST FL 6",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1359 N PACIFIC HWY",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "97071",
            "telephone_number": "503-982-0232",
            "fax_number": "503-873-6113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMAN",
        "first_name": "VIRGINIA",
        "middle_name": "SUSAN",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "3455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINGER",
            "last_name": "HOLMAN",
            "middle_name": "SUSAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Woodburn, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; 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.