Active NPI
Beverly Holloway, LMT
- Massage Therapist
- Winter Park, FL
National Provider Identifier
1649620055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA74582
- Practice address
- 1414 Gay Rd Ste 203
Winter Park, FL 32789-2928 - Phone
- (321) 356-5177
- Fax
- (877) 325-2279
- NPI assigned
- Jun 16, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA74582 | FL | Primary |
Addresses
Primary practice location
1414 Gay Rd Ste 203
Winter Park, FL 32789-2928
Mailing address
1328 Winnifred St
Orlando, FL 32805-3771
Phone (321) 356-5177
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA74582 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604275200000",
"number": "1649620055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1328 WINNIFRED ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328053771",
"telephone_number": "321-356-5177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1414 GAY RD STE 203",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327892928",
"telephone_number": "321-356-5177",
"fax_number": "877-325-2279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLOWAY",
"first_name": "BEVERLY",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-16",
"last_updated": "2020-11-02",
"certification_date": "2020-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA74582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.