Active NPI
Melanie Holler
- Physical Therapy Assistant
- Wilmington, NC
National Provider Identifier
1467600585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A5189
- Practice address
- 1402 Hospital Plaza Dr
Wilmington, NC 28401 - Phone
- (910) 762-1130
- NPI assigned
- Sep 3, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A5189 | NC | Primary |
Addresses
Primary practice location
1402 Hospital Plaza Dr
Wilmington, NC 28401
Mailing address
1402 Hospital Plaza Dr
Wilmington, NC 28401-6659
Phone (740) 262-0872
Other practice location 1
403 Linden Street
Marysville, OH 43040
Phone (937) 578-4061
Other practice location 2
1402 Hospital Plaza Dr
Wilmington, NC 28401
Phone (910) 762-1130
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | LHS-224@legacyinc.com |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A5189 | NC | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Healthcare Services, Inc. | Current | Accepting new patients | |
| Legacy Healthcare Services Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Physical Therapist
- Durham, NC
- NPI 1104823400
-
- Physical Therapist
- Cary, NC
- NPI 1225879489
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574121600000",
"number": "1467600585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1402 HOSPITAL PLAZA DR",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284016659",
"telephone_number": "740-262-0872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1402 HOSPITAL PLAZA DR",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "28401",
"telephone_number": "910-762-1130"
}
],
"practiceLocations": [
{
"address_1": "403 Linden Street",
"address_purpose": "LOCATION",
"city": "Marysville",
"state": "OH",
"postal_code": "43040",
"country_code": "US",
"telephone_number": "937-578-4061",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1402 Hospital Plaza Dr",
"address_purpose": "LOCATION",
"city": "Wilmington",
"state": "NC",
"postal_code": "28401",
"country_code": "US",
"telephone_number": "910-762-1130",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOLLER",
"first_name": "MELANIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-03",
"last_updated": "2019-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NC",
"license": "A5189",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "LHS-224@legacyinc.com",
"affiliation": "N",
"address_1": "1402 Hospital Plaza Dr",
"city": "Wilmington",
"state": "NC",
"country_code": "US",
"postal_code": "28401",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.