Hollie Deslatte Kelley, OTR/L, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

07767 Issued in LA

Practice address

1022 Chris Xing
Woodworth, LA 71485-4806

Phone

(225) 485-7876

NPI assigned

Apr 29, 2010

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1700103728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 CHRIS XING",
            "city": "WOODWORTH",
            "state": "LA",
            "postal_code": "714854806",
            "telephone_number": "225-485-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 CHRIS XING",
            "city": "WOODWORTH",
            "state": "LA",
            "postal_code": "714854806",
            "telephone_number": "225-485-7876"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4051 Bayou Rapides Rd",
            "address_2": "Apt #1102",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "LA",
            "postal_code": "713034012",
            "country_code": "US",
            "telephone_number": "225-485-7876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "HOLLIE",
        "middle_name": "DESLATTE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L, PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "LA",
            "license": "OTT.200366",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "07767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Woodworth, LA
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.

Verify at the official NPI Registry.