Lisa Michelle Holloway, OT, MHL, CAPS

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

104860 Issued in TX

Practice address

9328 Wood Duck Dr
Fort Worth, TX 76118-7784

Phone

(817) 891-3255

NPI assigned

Aug 5, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Lifestyle Transitions, PLLC

  • Occupational Therapist
  • Fort Worth, TX
  • NPI 1184226490
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1518577469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9328 WOOD DUCK DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761187784",
            "telephone_number": "817-891-3255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9328 WOOD DUCK DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761187784",
            "telephone_number": "817-891-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "LISA",
        "middle_name": "MICHELLE",
        "credential": "OT, MHL, CAPS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-05",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "104860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Scott Hollis
• Lilly Hollister, PA-C
• Christina Ann Holloway, FNP-C
• Dorothy Holloway
• Jeffrey Lynn Holloway, DO
• Shanikia Holloway
• Tiffany Holloway, PHARMD
• Clayton Forest Holmes, PT, EDD, ATC
• David L Holmes, MD
• Kara Holmes

• Occupational Therapist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; 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.