Individual provider Active NPI

Holly Landry, DPT

  • Physical Therapist
  • Beaver Dam, WI
National Provider Identifier
1588032767
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13121-24 Issued in WI
Practice address
134 Corporate Dr
Beaver Dam, WI 53916-3116
Phone
(920) 356-1000
NPI assigned
Sep 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 13121-24 WI Primary

Addresses

Primary practice location

134 Corporate Dr
Beaver Dam, WI 53916-3116

Mailing address

1515 Park Ave
Columbus, WI 53925-2402
Phone (920) 623-2200

Other names 1

  • Dr. Holly Anstey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151201002143 WI Practitioner - Physical Therapist in Private Practice 0648570473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prairie Ridge Health IncGroup PAC ID 6800791484, 70 clinicians

Practice addresses (Care Compare)

118 W Maple Ave
Beaver Dam, WI 53916-2104
Phone (920) 356-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13121-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prairie Ridge Health Inc. CurrentSince Sep 7, 2015 Accepting new patients
Prairie Ridge Health, Inc. CurrentSince Feb 6, 2022 Accepting new patients
Prairie Ridge Health, Inc. CurrentSince Sep 7, 2015 Accepting new patients

Locations

134 Corporate Dr
Beaver Dam, WI 53916
Phone (920) 356-1000

118 W Maple Ave
Beaver Dam, WI 53916
Phone (920) 356-1000

1515 Park Ave
Columbus, WI 53925
Phone (920) 623-1200

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/a87187e5-fe2f-447e-bf32-4eeb3954a735/

Organizations & group practices 3

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": "1441324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1588032767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 PARK AVE",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539252402",
            "telephone_number": "920-623-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 CORPORATE DR",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163116",
            "telephone_number": "920-356-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "HOLLY",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-04",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13121-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "ANSTEY",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Beaver Dam, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.