Individual provider Active NPI

Mary S Holzman, PTA

  • Physical Therapy Assistant
  • Kalaheo, HI
National Provider Identifier
1790026664
Registry record updated Mar 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1349 Issued in CA
Practice address
2-2514 Kaumualii Hwy
Suite 205
Kalaheo, HI 96741-8303
Phone
(808) 333-3688
NPI assigned
Mar 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1349 CA Primary
Massage Therapist 225700000X 6392 HI

Addresses

Primary practice location

2-2514 Kaumualii Hwy
Suite 205
Kalaheo, HI 96741-8303

Mailing address

5200 Paanau Rd
Apt O203
Koloa, HI 96756-9430
Phone (808) 639-8544

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

LicenseStateTypeSpecialty
6392HIMDMassage Therapist
1349CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1362096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362096000000",
    "number": "1790026664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 PAANAU RD",
            "address_2": "APT O203",
            "city": "KOLOA",
            "state": "HI",
            "postal_code": "967569430",
            "telephone_number": "808-639-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2-2514 KAUMUALII HWY",
            "address_2": "SUITE 205",
            "city": "KALAHEO",
            "state": "HI",
            "postal_code": "967418303",
            "telephone_number": "808-333-3688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLZMAN",
        "first_name": "MARY",
        "middle_name": "S",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-01",
        "last_updated": "2013-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "1349",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "HI",
            "license": "6392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalaheo, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2013; 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.