Individual provider Active NPI

Olivia Louise Holmes

  • Behavior Technician
  • Collierville, TN
National Provider Identifier
1457922320
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1125 Schilling Blvd E Ste 112
Collierville, TN 38017-7078
Phone
(901) 248-7440
NPI assigned
Jul 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 8033 TN
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

1125 Schilling Blvd E Ste 112
Collierville, TN 38017-7078

Mailing address

1125 Schilling Blvd E Ste 112
Collierville, TN 38017-7078
Phone (901) 248-7440

Other practice location 1

6286 Briarcrest Ave Ste 110
Memphis, TN 38120-4023
Phone (901) 259-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240730003228 TN Practitioner - Occupational Therapist in Private Practice 7416494190 Reassigns benefits to 1 organization
I20240827002237 MS Practitioner - Occupational Therapist in Private Practice 7416494190 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
MSK Group PC CurrentSince Aug 13, 2024 Accepting new patients
MSK Group, PC Occupational Therapist CurrentSince Jul 12, 2024 Accepting new patients
MSK Group, PC CurrentSince Jul 12, 2024 Accepting new patients
Shelby County Board of Education Past Accepting new patients

Locations

7580 Clarington Cv
Southaven, MS 38671
Phone (901) 259-1600

7111 Southcrest Pkwy
Ste 105
Southaven, MS 38671
Phone (901) 261-2506

6286 Briarcrest Ave
Ste 100
Memphis, TN 38120
Phone (901) 259-1600

6077 E Primacy Pkwy
Ste 140
Memphis, TN 38119
Phone (901) 725-8347

6286 Briarcrest Ave
#200
Memphis, TN 38120
Phone (901) 259-1600

6286 Briarcrest Ave
Ste 110
Memphis, TN 38120
Phone (901) 259-1600

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1457922320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 SCHILLING BLVD E STE 112",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380177078",
            "telephone_number": "901-248-7440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 SCHILLING BLVD E STE 112",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380177078",
            "telephone_number": "901-248-7440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6286 Briarcrest Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381204023",
            "country_code": "US",
            "telephone_number": "901-259-1600",
            "fax_number": "901-259-1698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "OLIVIA",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-01",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "8033",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collierville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.