Randall Odvar Holm, LMT 5009

Primary specialty

Massage TherapistTaxonomy code 225700000X

Practice address

1104 Bradshaw Dr
Florence, AL 35630-1438

Phone

(256) 229-3665

NPI assigned

May 15, 2020

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

Other names 1

• Randall Odvar Holm Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1366064081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 BLAKE AVE",
            "city": "MUSCLE SHOALS",
            "state": "AL",
            "postal_code": "356611206",
            "telephone_number": "256-366-2261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 BRADSHAW DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301438",
            "telephone_number": "256-229-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLM",
        "first_name": "RANDALL",
        "middle_name": "ODVAR",
        "credential": "LMT 5009",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-15",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANDALL",
            "last_name": "HOLM",
            "middle_name": "ODVAR",
            "credential": "LMT 5009",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Matthew Holland, PHARMD
• Jason Blake Hollander, CRNA
• Cherish Holley
• Katie Holliday, PT, DPT
• Kristina Hollingsworth, CRNP
• Amy Southern Holt, CRNP
• Gene Ellen Brumley Holt, CRNA
• Jonathan Burnett Holt, CRNA
• Karly Holt
• Brittney Hood, CRNP

• All providers in Florence, AL
• Massage Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; 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.