NPIMap

Organization Active NPI

Holy City Pediatric Therapy LLC

  • Clinic/Center
  • Daniel Island, SC
National Provider Identifier
1639568231
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
3907 Issued in SC
Legal business name
HOLY CITY PEDIATRIC THERAPY LLC
Doing business as
Holy City Pediatric Therapy, LLC
Practice address
142 Sportsman Island Dr Ste E
Daniel Island, SC 29492-8524
Phone
(423) 388-8311
NPI assigned
Jan 20, 2015
Last updated
Aug 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Authorized official

Name
Kellye Tolley, OTR/LNPI 1760756688
Title
Occupational Therapist
Phone
(423) 388-5198

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Clinic/Center 261Q00000X 3907 SC Primary

Addresses

Primary practice location

142 Sportsman Island Dr Ste E
Daniel Island, SC 29492-8524

Mailing address

2030 Wambaw Creek Rd Ste 200
Charleston, SC 29492-8382
Phone (843) 708-9138

Other practice location 1

2030 Wambaw Creek Rd Ste 200
Charleston, SC 29492-8382
Phone (843) 708-9138

Other names 1

  • Holy City Pediatric Therapy, LLC Doing business as

National Provider Directory

National Provider Directory

Locations

2030 Wambaw Creek Rd
Ste 200
Charleston, SC 29492

142 Sportsman Island Dr
Ste E
Daniel Island, SC 29492
Phone (843) 696-2174

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1421712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787529600000",
    "number": "1639568231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 WAMBAW CREEK RD STE 200",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294928382",
            "telephone_number": "843-708-9138",
            "fax_number": "888-659-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 SPORTSMAN ISLAND DR STE E",
            "city": "DANIEL ISLAND",
            "state": "SC",
            "postal_code": "294928524",
            "telephone_number": "423-388-8311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2030 Wambaw Creek Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294928382",
            "country_code": "US",
            "telephone_number": "843-708-9138",
            "fax_number": "888-659-8008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HOLY CITY PEDIATRIC THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-20",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A",
        "authorized_official_last_name": "TOLLEY",
        "authorized_official_first_name": "KELLYE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "423-388-5198",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "SC",
            "license": "3907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holy City Pediatric Therapy, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Daniel Island, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.