Jeremy Holman, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

42120 Issued in CA

Practice address

3145 Rosecrans St Ste F
San Diego, CA 92110-4831

Phone

(619) 223-7475

Fax

(619) 223-7030

NPI assigned

Jan 22, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Group practices

Barbara Jean Boutelle Carlsbad Physical TherapyGroup PAC ID 4082527189, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Barbara Jean Boutelle Carlsbad Physical Therapy

  • Physical Therapist
  • Carlsbad, CA
  • NPI 1669420980
  Medicare reassignment Care Compare group NPD
• Barbara Jean Boutelle Carlsbad Physical Therapy

  dba San Luis Rey Physical Therapy and Hand Center

  • Physical Therapist
  • Oceanside, CA
  • NPI 1255007050
  NPD
• Barbara Jean Boutelle Carlsbad Physical Therapy

  dba Scripps Ranch Physical Therapy and Hand Center

  • Physical Therapist
  • San Diego, CA
  • NPI 1699723098
  NPD (past)

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1639568017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 MADISON ST",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920082310",
            "telephone_number": "760-591-7750",
            "fax_number": "760-471-5139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3145 ROSECRANS ST STE F",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104831",
            "telephone_number": "619-223-7475",
            "fax_number": "619-223-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMAN",
        "first_name": "JEREMY",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-22",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "42120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CALIFORNIA PHYSICAL THERAPY LICENSE",
            "identifier": "42120",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Lynn Holm, RDN
• Tiffany Holm, APRN
• Abigail Patricia Holman, RBT
• Dawn A Holman, BCBA-D
• Eileen Louise Holman, LCSW
• John C Holman III, D.D.S.
• Kelley Ann Holman
• Kellsie Holman
• Michael Joseph Holman, M.D.
• Peter R Holman, MD

• Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.