Active NPI
Timothy Demetrius Holley, O.T.R./L
- Occupational Therapist
- Birmingham, AL
National Provider Identifier
1598955502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2479
- Practice address
- 833 Princeton Ave SW
Birmingham, AL 35211-1323 - Phone
- (205) 780-7053
- Fax
- (205) 206-8300
- NPI assigned
- Jul 26, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2479 | AL | Primary |
Addresses
Primary practice location
833 Princeton Ave SW
Birmingham, AL 35211-1323
Mailing address
1945 Scottsville Rd
B2, Pmb356
Bowling Green, KY 42104-3376
Phone (270) 842-8824
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2479 | AL | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185408000000",
"number": "1598955502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1945 SCOTTSVILLE RD",
"address_2": "B2, PMB356",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421043376",
"telephone_number": "270-842-8824",
"fax_number": "270-842-7917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "833 PRINCETON AVE SW",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352111323",
"telephone_number": "205-780-7053",
"fax_number": "205-206-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLEY",
"first_name": "TIMOTHY",
"middle_name": "DEMETRIUS",
"name_prefix": "Mr.",
"credential": "O.T.R./L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-26",
"last_updated": "2007-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AL",
"license": "2479",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.