Individual provider Active NPI

William J Holman, RPT

  • Physical Therapist
  • Demopolis, AL
National Provider Identifier
1639182108
Registry record updated Aug 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
19747 Issued in AL
Practice address
101 US Highway 80 W
Demopolis, AL 36732-4101
Phone
(334) 289-5696
Fax
(334) 289-5578
NPI assigned
Aug 14, 2006
Last updated
Aug 24, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2009

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 19747 AL Primary

Addresses

Primary practice location

101 US Highway 80 W
Demopolis, AL 36732-4101

Mailing address

101 US Highway 80 W
Demopolis, AL 36732-4101
Phone (334) 289-5696

Other identifiers 1

IdentifierTypeStateIssuer
529927890MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050706000776 AL Practitioner - Physical Therapist in Private Practice 8527004613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 US Hwy 80 W
Demopolis, AL 36732-4101
Phone (334) 289-5696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19747ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Rehab, Inc. Current Accepting new patients
Genesis Rehabilitation, Inc. Dba Fyzical Therapy and Balance Center CurrentSince Apr 28, 2005 Accepting new patients

Locations

101 US Highway 80 W
Demopolis, AL 36732
Phone (334) 289-5696

Organizations & group practices 2

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251072000000",
    "number": "1639182108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 US HIGHWAY 80 W",
            "city": "DEMOPOLIS",
            "state": "AL",
            "postal_code": "367324101",
            "telephone_number": "334-289-5696",
            "fax_number": "334-289-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 US HIGHWAY 80 W",
            "city": "DEMOPOLIS",
            "state": "AL",
            "postal_code": "367324101",
            "telephone_number": "334-289-5696",
            "fax_number": "334-289-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMAN",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2009-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "19747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529927890",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Demopolis, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2009; 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.