Active NPI
Holly Paige Fennell
- Physical Therapist
- Florence, KY
National Provider Identifier
1598894982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 004186
- Practice address
- 6193 Ridgewood CT
Florence, KY 41042-9777 - Phone
- (859) 647-0304
- Fax
- (859) 647-4052
- NPI assigned
- Mar 3, 2007
- 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 Therapist | 225100000X | 004186 | KY | Primary |
Addresses
Primary practice location
6193 Ridgewood CT
Florence, KY 41042-9777
Mailing address
6193 Ridgewood CT
Florence, KY 41042-9777
Phone (859) 647-0304
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 |
|---|---|---|---|
| 004186 | KY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598894982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6193 RIDGEWOOD CT",
"city": "FLORENCE",
"state": "KY",
"postal_code": "410429777",
"telephone_number": "859-647-0304",
"fax_number": "859-647-4052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6193 RIDGEWOOD CT",
"city": "FLORENCE",
"state": "KY",
"postal_code": "410429777",
"telephone_number": "859-647-0304",
"fax_number": "859-647-4052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENNELL",
"first_name": "HOLLY",
"middle_name": "PAIGE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KY",
"license": "004186",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florence, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.