Jefferson Wayne Holm, DPT, PT, CBIS

Primary specialty

Neurology Physical TherapistTaxonomy code 2251N0400X

License

9343 Issued in AZ

Practice address

3961 E Guadalupe Rd Ste 1
Gilbert, AZ 85234-3266

Phone

(480) 699-4845

Fax

(480) 699-5085

NPI assigned

Jul 25, 2013

Last updated

Aug 14, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Pittsburgh School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Neurologic RehabilitationGroup PAC ID 5395055859, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Advanced Neurologic Rehabilitation

  • Physical Therapy Clinic/Center
  • Chandler, AZ
  • NPI 1922482017
  Medicare reassignment Care Compare group NPD Authorized official
• Anr Diagnostic LLC

  dba Advanced Neurologic Rehabilitation

  • Diagnostic Radiology Physician
  • Gilbert, AZ
  • NPI 1467288159
  NPD Authorized official
• Advanced Neurologic Rehabilitation

  • Physical Therapy Clinic/Center
  • Chandler, AZ
  • NPI 1598188096
  NPD (past) Authorized official
• Advanced Neurologic Rehabilitation

  • Rehabilitation Clinic/Center
  • Gilbert, AZ
  • NPI 1518688746
  NPD

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1740622109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3160 N ARIZONA AVE STE 106",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852257122",
            "telephone_number": "480-244-7011",
            "fax_number": "480-699-5085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3961 E GUADALUPE RD STE 1",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852343266",
            "telephone_number": "480-699-4845",
            "fax_number": "480-699-5085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3160 N Arizona Ave Ste 106",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852257122",
            "country_code": "US",
            "telephone_number": "480-699-4585",
            "fax_number": "480-699-5085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLM",
        "first_name": "JEFFERSON",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "DPT, PT, CBIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-25",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "CA",
            "license": "39016",
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "AZ",
            "license": "9343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Holloway, DC
• Kristan Leigh Holloway, DPT
• Miriam Holloway
• Mary E Hollowell
• Hannah Holly
• Jennifer Jean Holman, MED, BCBA
• Isabella Holmen
• Christine Phillips Holmes, MD
• Lashae Janelle Holmes, M.ED., BCBA, LBA
• Amanda J Holmquist, MD

• Neurology Physical Therapist in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Neurology Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.