NPIMap

Organization Active NPI

Holly a. Nelson, Pediatric Occupational Therapy, LLC

  • Specialist
  • Baltimore, MD
National Provider Identifier
1336499722
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
03646 Issued in MD
Legal business name
HOLLY A. NELSON, PEDIATRIC OCCUPATIONAL THERAPY, LLC
Practice address
3811 Crestvale Ter
Baltimore, MD 21236-5201
Phone
(410) 882-1345
NPI assigned
Sep 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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

Authorized official

Name
Holly Nelson, OTR/LNPI 1154920866
Title
Owner
Phone
(410) 882-1345

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 03646 MD Primary

Addresses

Primary practice location

3811 Crestvale Ter
Baltimore, MD 21236-5201

Mailing address

3811 Crestvale Ter
Baltimore, MD 21236-5201

Other identifiers 1

IdentifierTypeStateIssuer
KCN6HOOtherMDCAREFIRST BLUECROSS BLUE SHIELD NON-PARTICIPATING PROVIDER NUMBER

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347494400000",
    "number": "1336499722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 CRESTVALE TER",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212365201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 CRESTVALE TER",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212365201",
            "telephone_number": "410-882-1345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY A. NELSON, PEDIATRIC OCCUPATIONAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-13",
        "last_updated": "2012-09-13",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-882-1345",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "03646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUECROSS BLUE SHIELD NON-PARTICIPATING PROVIDER NUMBER",
            "identifier": "KCN6HO",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; 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.