Individual provider Active NPI

Kelly Holland

  • Physical Therapist
  • Chandler, AZ
National Provider Identifier
1700264587
Registry record updated May 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6341 Issued in AZ
Practice address
1076 W Chandler Blvd
103
Chandler, AZ 85224-5225
Phone
(480) 821-1997
Fax
(480) 782-5213
NPI assigned
May 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6341 AZ Primary

Addresses

Primary practice location

1076 W Chandler Blvd
103
Chandler, AZ 85224-5225

Mailing address

1076 W Chandler Blvd
103
Chandler, AZ 85224-5225
Phone (480) 821-1997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250324002267 CA Practitioner - Physical Therapist in Private Practice 8123330958 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beth Scalone PT IncGroup PAC ID 6608848049, 7 clinicians
CRS Physical Therapy Inc.Group PAC ID 1355508433, 55 clinicians

Practice addresses (Care Compare)

15373 Innovation Dr
Suite 175
San Diego, CA 92128-3427
Phone (858) 675-1133

4501 Mission Bay Dr
San Diego, CA 92109-4926
Phone (858) 866-0340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6341AZMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Holland Spine Physical Therapy Inc Current Accepting new patients
Beth Scalone PT, Inc Physical Therapist CurrentSince Mar 10, 2025 Accepting new patients
CRS Physical Therapy Inc. Physical Therapist CurrentSince Oct 22, 2025 Accepting new patients

Locations

2657 Ariane Dr
San Diego, CA 92117
Phone (619) 453-0953

12171 World Trade Dr
San Diego, CA 92128
Phone (858) 217-2137

15373 Innovation Dr
Ste 175
San Diego, CA 92128
Phone (858) 675-1133

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431388800000",
    "number": "1700264587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1076 W CHANDLER BLVD",
            "address_2": "103",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245225",
            "telephone_number": "480-821-1997",
            "fax_number": "480-782-5213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 W CHANDLER BLVD",
            "address_2": "103",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245225",
            "telephone_number": "480-821-1997",
            "fax_number": "480-782-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-12",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "6341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; 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.