Individual provider Active NPI

Maggie Rose Hoelzeman, PT, DPT

  • Physical Therapist
  • Russellville, AR
National Provider Identifier
1346786043
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5082 Issued in AR
Practice address
1301 Russell Rd
Russellville, AR 72802-4320
Phone
(479) 967-2316
Fax
(479) 967-3639
NPI assigned
Jan 18, 2017
Last updated
Jan 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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 PT5082 AR Primary

Addresses

Primary practice location

1301 Russell Rd
Russellville, AR 72802-4320

Mailing address

PO Drawer 2109
Russellville, AR 72811
Phone (479) 967-2322

Other practice location 1

208 Gina Dr
Morrilton, AR 72110-4726
Phone (501) 215-9520

Other identifiers 1

IdentifierTypeStateIssuer
281789721MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220701000093 AR Practitioner - Physical Therapist in Private Practice 2769862143

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1484697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1346786043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO DRAWER 2109",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72811",
            "telephone_number": "479-967-2322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 RUSSELL RD",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728024320",
            "telephone_number": "479-967-2316",
            "fax_number": "479-967-3639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 Gina Dr",
            "address_purpose": "LOCATION",
            "city": "Morrilton",
            "state": "AR",
            "postal_code": "721104726",
            "country_code": "US",
            "telephone_number": "501-215-9520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOELZEMAN",
        "first_name": "MAGGIE",
        "middle_name": "ROSE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-18",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT5082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281789721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.