Individual provider Active NPI

Leanne Nelle Holm, M.ED, ATC/L

  • Specialist
  • Indianapolis, IN
National Provider Identifier
1295747939
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
36000715A Issued in IN
Practice address
201 Pennsylvania Pkwy Ste 200
Indianapolis, IN 46280-1393
Phone
(317) 817-1200
NPI assigned
Aug 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 36000715A IN Primary

Addresses

Primary practice location

201 Pennsylvania Pkwy Ste 200
Indianapolis, IN 46280-1393

Mailing address

2512 E 58TH St
Indianapolis, IN 46220-5804
Phone (317) 251-7021

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)
Not enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
36000715AINMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295747939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 E 58TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462205804",
            "telephone_number": "317-251-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PENNSYLVANIA PKWY STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462801393",
            "telephone_number": "317-817-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLM",
        "first_name": "LEANNE",
        "middle_name": "NELLE",
        "credential": "M.ED, ATC/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "36000715A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.