Individual provider Active NPI

Kimberly Suzanne Holt, OTR

  • Occupational Therapist
  • Port Arthur, TX
National Provider Identifier
1740460385
Registry record updated Nov 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
8700 9TH Ave
Suite 103
Port Arthur, TX 77642-8030
Phone
(409) 722-5437
Fax
(409) 722-5435
NPI assigned
Nov 12, 2007
Sex
Female
Sole proprietor
Yes

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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

8700 9TH Ave
Suite 103
Port Arthur, TX 77642-8030

Mailing address

115 Spanish Trce
Silsbee, TX 77656-8928
Phone (409) 722-5437

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
110218OtherTXEXECUTIVE COUNCIL OT

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 12, 2007.

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194825600000",
    "number": "1740460385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 SPANISH TRCE",
            "city": "SILSBEE",
            "state": "TX",
            "postal_code": "776568928",
            "telephone_number": "409-722-5437",
            "fax_number": "409-722-5435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 9TH AVE",
            "address_2": "SUITE 103",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776428030",
            "telephone_number": "409-722-5437",
            "fax_number": "409-722-5435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "KIMBERLY",
        "middle_name": "SUZANNE",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-12",
        "last_updated": "2007-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXECUTIVE COUNCIL OT",
            "identifier": "110218",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Arthur, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2007; 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.