Jack Tyler Hollabaugh, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14712 Issued in NC

Practice address

2014 Litho PL
Fayetteville, NC 28304-2518

Phone

(910) 484-2091

Fax

(910) 483-7456

NPI assigned

Feb 25, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Benchmark Physical Therapy of North Carolina, LLCGroup PAC ID 1052609278, 242 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Benchmark Physical Therapy of North Carolina LLC

  • Physical Therapist
  • Ooltewah, TN
  • NPI 1356894604

  NC

  Medicare reassignment Care Compare group NPD
• Benchmark Physical Therapy of NC, LLC

  • Physical Therapist
  • Leland, NC
  • NPI 1588189112
  NPD
• Benchmark Physical Therapy of NC, LLC

  • Physical Therapist
  • Charlotte, NC
  • NPI 1700315819
  NPD

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

{
    "created_epoch": "1393286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1295150472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-682-8840",
            "fax_number": "423-602-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 LITHO PL",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283042518",
            "telephone_number": "910-484-2091",
            "fax_number": "910-483-7456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLABAUGH",
        "first_name": "JACK",
        "middle_name": "TYLER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-25",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "14712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melody Holden
• Kasey Holder
• Holding Hope Counseling, PLLC
• Kendle Holeman, MSW, LCSW-A
• Holistic Services LLC
• Debra Holland Perkins, RN
• Jenny D Holland, OCCUPATIONAL THERAPI
• Kathleen V Holland, O.D.
• Rocha Madleine Holland
• Sonya Renee Holland, LPC

• Physical Therapist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Physical Therapist in North Carolina

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