Active NPI
Holly Erin Phillips, PT, DPT
- Physical Therapist
- Indianapolis, IN
National Provider Identifier
1821496985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05014906A
- Practice address
- 6040 W 84TH St
Indianapolis, IN 46278-1360 - Phone
- (317) 956-1080
- NPI assigned
- Dec 5, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070021768 | IL | |
| Physical Therapist | 225100000X | 12813-24 | WI | |
| Physical Therapist | 225100000X | 05014906A | IN | Primary |
Addresses
Primary practice location
6040 W 84TH St
Indianapolis, IN 46278-1360
Mailing address
6040 W 84TH St
Indianapolis, IN 46278-1360
Phone (317) 956-1080
Other names 1
- Dr. Holly Erin O'Brien
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070021768 | IL | MD | Physical Therapist |
| 05014906A | IN | MD | Physical Therapist |
| 12813-24 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sport & Spine Clinic of Fort Atkinson Limited Partnership | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Johnson Creek, WI
- NPI 1093207904
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676332800000",
"number": "1821496985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6040 W 84TH ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462781360",
"telephone_number": "317-956-1080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6040 W 84TH ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462781360",
"telephone_number": "317-956-1080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "HOLLY",
"middle_name": "ERIN",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-05",
"last_updated": "2023-02-14",
"certification_date": "2023-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070021768",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "12813-24",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05014906A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "HOLLY",
"last_name": "O'BRIEN",
"middle_name": "ERIN",
"prefix": "DR.",
"credential": "PT, DPT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.