Individual provider Active NPI

Hannah Jo Holloway, PT, DPT

  • Physical Therapist
  • Evans, GA
National Provider Identifier
1609442177
Registry record updated Mar 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14875 Issued in TN
Practice address
536 Grand Slam Dr Ste D
Evans, GA 30809-8045
Phone
(706) 854-8434
NPI assigned
Jun 3, 2021
Last updated
Mar 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT015253 GA
Physical Therapist 225100000X 14875 TN Primary

Addresses

Primary practice location

536 Grand Slam Dr Ste D
Evans, GA 30809-8045

Mailing address

5115 Huntley TRL
Harlem, GA 30814-5150
Phone (925) 518-7529

Other names 1

  • Hannah Jo Waples Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230531001432 TN Practitioner - Physical Therapist in Private Practice 1254798606 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT015253GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Trails of Evans CurrentSince Jun 6, 2021 Accepting new patients
Feltz Therapy Services, LLC Physical Therapist CurrentSince Apr 10, 2023 Accepting new patients
Shine Pediatric Therapy Physical Therapist Past Accepting new patients

Locations

536 Grand Slam Dr
Ste D
Evans, GA 30809
Phone (706) 842-3330

1173 Rock Springs Rd
Ste 105
Smyrna, TN 37167
Phone (615) 220-5756

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679702400000",
    "number": "1609442177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 HUNTLEY TRL",
            "city": "HARLEM",
            "state": "GA",
            "postal_code": "308145150",
            "telephone_number": "925-518-7529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 GRAND SLAM DR STE D",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308098045",
            "telephone_number": "706-854-8434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "HANNAH",
        "middle_name": "JO",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2023-03-25",
        "certification_date": "2023-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT015253",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "14875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HANNAH",
            "last_name": "WAPLES",
            "middle_name": "JO",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2023; 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.