Individual provider Active NPI

Elizabeth Holman

  • Occupational Therapist
  • Keller, TX
National Provider Identifier
1508438920
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
121937 Issued in TX
Practice address
1652 Keller Pkwy Ste 100
Keller, TX 76248-3876
Phone
(817) 562-3111
NPI assigned
Jul 14, 2021
Last updated
Jul 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 121937 TX Primary

Addresses

Primary practice location

1652 Keller Pkwy Ste 100
Keller, TX 76248-3876

Mailing address

5817 Sandshell Cir W Apt 6201
Fort Worth, TX 76137-7006
Phone (662) 719-2443

Other names 1

  • Elizabeth Baugh Former name

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

LicenseStateTypeSpecialty
121937TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapedia, LLC CurrentSince Jul 25, 2021 Accepting new patients

Locations

17516 Matany Rd
Ste 100
Justin, TX 76247
Phone (714) 904-2003

1652 Keller Pkwy
Ste 100
Keller, TX 76248
Phone (817) 562-3111

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": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1508438920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5817 SANDSHELL CIR W APT 6201",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761377006",
            "telephone_number": "662-719-2443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1652 KELLER PKWY STE 100",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483876",
            "telephone_number": "817-562-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMAN",
        "first_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "121937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "BAUGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Keller, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.