Individual provider Active NPI

Tamara Ann Holtz, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Phoenix, AZ
National Provider Identifier
1417094103
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4026 Issued in AZ
Practice address
20815 N 25TH PL
Suite 105
Phoenix, AZ 85050-4608
Phone
(602) 404-8102
Fax
(602) 466-2834
NPI assigned
Jan 31, 2007
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
Speech-Language Pathologist 235Z00000X 4026 AZ Primary

Addresses

Primary practice location

20815 N 25TH PL
Suite 105
Phoenix, AZ 85050-4608

Mailing address

20815 N 25TH PL
Suite 105
Phoenix, AZ 85050-4608
Phone (602) 404-8102

Other identifiers 1

IdentifierTypeStateIssuer
775588OtherAZAHCCCS

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 Science

Practice roles

OrganizationSpecialtyStatusNew patients
Activities for Development, Inc. Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417094103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20815 N 25TH PL",
            "address_2": "SUITE 105",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504608",
            "telephone_number": "602-404-8102",
            "fax_number": "602-466-2834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20815 N 25TH PL",
            "address_2": "SUITE 105",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504608",
            "telephone_number": "602-404-8102",
            "fax_number": "602-466-2834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTZ",
        "first_name": "TAMARA",
        "middle_name": "ANN",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "4026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "775588",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

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.