Active NPI
Holly Erin Thompson
- Physical Therapy Assistant
- Clayton, MO
National Provider Identifier
1508549403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2023031676
- Practice address
- 401 Corporate Park Dr
Clayton, MO 63105-4201 - Phone
- (314) 725-7447
- NPI assigned
- Aug 8, 2023
- 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 | 2023031676 | MO | Primary |
Addresses
Primary practice location
401 Corporate Park Dr
Clayton, MO 63105-4201
Mailing address
22 Ginger Ridge LN
Glen Carbon, IL 62034-3404
Phone (804) 814-8423
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 |
|---|---|---|---|
| 2023031676 | MO | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691452800000",
"number": "1508549403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 GINGER RIDGE LN",
"city": "GLEN CARBON",
"state": "IL",
"postal_code": "620343404",
"telephone_number": "804-814-8423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 CORPORATE PARK DR",
"city": "CLAYTON",
"state": "MO",
"postal_code": "631054201",
"telephone_number": "314-725-7447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "HOLLY",
"middle_name": "ERIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-08",
"last_updated": "2023-08-08",
"certification_date": "2023-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MO",
"license": "2023031676",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clayton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.