Holly E Surber, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1999137493 Issued in MO

Practice address

605 Old Ballas Rd Ste 128
Creve Coeur, MO 63141-7070

Phone

(314) 801-8776

NPI assigned

Aug 22, 2006

Last updated

Mar 1, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Holly E Devenport Former name

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Junction Bracing and PTGroup PAC ID 8729405238, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Junction Bracing & PT

  dba EmBrace

  • Orthopedic Physical Therapist
  • Imperial, MO
  • NPI 1801419601
  Medicare reassignment Care Compare group NPD
• Junction Bracing & PT LLC

  dba EmBrace

  • Physical Therapist
  • Saint Louis, MO
  • NPI 1437800026
  NPD
• SSM Select Rehab St. Louis, LLC

  dba SSM Physical Therapy

  • Rehabilitation Practitioner
  • Breese, IL
  • NPI 1740166347
  NPD (past)

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1649386426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 OLD BALLAS RD STE 128",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417070",
            "telephone_number": "314-801-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 OLD BALLAS RD STE 128",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417070",
            "telephone_number": "314-801-8776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURBER",
        "first_name": "HOLLY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2022-03-01",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "1999137493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "DEVENPORT",
            "middle_name": "E",
            "prefix": "MISS",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Suburban Foot Care
• Thomas Evan Suddeth
• Allyson Suiter
• Hailey Jo Sullivan
• Sunshine Healthcare, LLC
• Surevision Eye Centers Midwest LLC (SureVision Eye Centers)
• Surevision Eye Centers Midwest LLC (SureVision Optical Shops)
• Surgery Centers of Missouri
• Surgery Centers of Missouri, LLC
• Surgical Center of Creve Coeur

• Physical Therapist in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.