Active NPI
Jerri L. Holloway, BS
- Physical Therapist
- Johnstown, NY
National Provider Identifier
1295971042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 008285
- Practice address
- 2755 State Highway 67
Johnstown, NY 12095-3747 - Phone
- (518) 736-4350
- NPI assigned
- Dec 29, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 008285 | NY | Primary |
Addresses
Primary practice location
2755 State Highway 67
Johnstown, NY 12095-3747
Mailing address
2755 State Highway 67
Johnstown, NY 12095-3747
Phone (518) 736-4350
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
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008285 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283212800000",
"number": "1295971042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2755 STATE HIGHWAY 67",
"city": "JOHNSTOWN",
"state": "NY",
"postal_code": "120953747",
"telephone_number": "518-736-4350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2755 STATE HIGHWAY 67",
"city": "JOHNSTOWN",
"state": "NY",
"postal_code": "120953747",
"telephone_number": "518-736-4350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLOWAY",
"first_name": "JERRI",
"middle_name": "L.",
"credential": "BS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-29",
"last_updated": "2010-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "008285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johnstown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.