Active NPI
Holly Superlano, PTA
- Physical Therapy Assistant
- Richmond, VA
National Provider Identifier
1699436840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2306604934
- Practice address
- 9100 Bon Air Crossings Dr
Richmond, VA 23235 - Phone
- (804) 709-0784
- NPI assigned
- Jan 9, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2306604934 | VA | Primary |
Addresses
Primary practice location
9100 Bon Air Crossings Dr
Richmond, VA 23235
Mailing address
6442 Burnt Mills LN
Moseley, VA 23120
Phone (563) 940-7288
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 |
|---|---|---|---|
| 2306604934 | VA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641686400000",
"number": "1699436840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6442 BURNT MILLS LN",
"city": "MOSELEY",
"state": "VA",
"postal_code": "23120",
"telephone_number": "563-940-7288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9100 BON AIR CROSSINGS DR",
"city": "RICHMOND",
"state": "VA",
"postal_code": "23235",
"telephone_number": "804-709-0784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUPERLANO",
"first_name": "HOLLY",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-09",
"last_updated": "2022-01-09",
"certification_date": "2022-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "VA",
"license": "2306604934",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.