Active NPI
Jeffrey Hollingbery, PT
- Physical Therapist
- Lacey, WA
National Provider Identifier
1831282243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00002220
- Practice address
- 669 Woodland Square Loop SE
Suite C
Lacey, WA 98503-1038 - Phone
- (360) 923-5323
- Fax
- (360) 923-5531
- NPI assigned
- Sep 30, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00002220 | WA | Primary |
Addresses
Primary practice location
669 Woodland Square Loop SE
Suite C
Lacey, WA 98503-1038
Mailing address
669 Woodland Square Loop SE
Suite C
Lacey, WA 98503-1038
Phone (360) 923-5323
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0166365 | Other | WA | LABOR & INDUSTRY NUMBER |
| 8141608 | Medicaid | WA |
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 |
|---|---|---|---|
| PT00002220 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hollingbery Physical Therapy | 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
- Lacey, WA
- NPI 1215020623
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1831282243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "669 WOODLAND SQUARE LOOP SE",
"address_2": "SUITE C",
"city": "LACEY",
"state": "WA",
"postal_code": "985031038",
"telephone_number": "360-923-5323",
"fax_number": "360-923-5531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "669 WOODLAND SQUARE LOOP SE",
"address_2": "SUITE C",
"city": "LACEY",
"state": "WA",
"postal_code": "985031038",
"telephone_number": "360-923-5323",
"fax_number": "360-923-5531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLINGBERY",
"first_name": "JEFFREY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-30",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00002220",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRY NUMBER",
"identifier": "0166365",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8141608",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lacey, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.