Active NPI
Olaf M Holm, LPO
- Prosthetist
- Tampa, FL
National Provider Identifier
1740797901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetist
- License
- POR124
- Practice address
- 812 W MLK Blvd Ste 100
Tampa, FL 33603-3338 - Phone
- (813) 224-0525
- Fax
- (813) 224-0622
- NPI assigned
- Jan 9, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | POR124 | FL | |
| Prosthetist | 224P00000X | POR124 | FL | Primary |
Addresses
Primary practice location
812 W MLK Blvd Ste 100
Tampa, FL 33603-3338
Mailing address
812 W MLK Blvd Ste 100
Tampa, FL 33603-3338
Phone (813) 224-0525
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005843900 | Medicaid | FL |
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 |
|---|---|---|---|
| POR124 | FL | MD | Prosthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tampa Bay Orthopaedic Designs Inc | Orthotist | Past | Accepting new patients |
| Tampa Bay Orthopaedic Designs, Inc. | Orthotist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Prosthetic/Orthotic Supplier
- Brandon, FL
- NPI 1861685083
Orthotist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515456000000",
"number": "1740797901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "812 W MLK BLVD STE 100",
"city": "TAMPA",
"state": "FL",
"postal_code": "336033338",
"telephone_number": "813-224-0525",
"fax_number": "813-224-0622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "812 W MLK BLVD STE 100",
"city": "TAMPA",
"state": "FL",
"postal_code": "336033338",
"telephone_number": "813-224-0525",
"fax_number": "813-224-0622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLM",
"first_name": "OLAF",
"middle_name": "M",
"credential": "LPO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-09",
"last_updated": "2018-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": "FL",
"license": "POR124",
"primary": false
},
{
"code": "224P00000X",
"taxonomy_group": "",
"desc": "Prosthetist",
"state": "FL",
"license": "POR124",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "005843900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.