Individual provider Active NPI

Jonathan McKey Holleman, PT, DPT

  • Physical Therapist
  • Johns Island, SC
National Provider Identifier
1841826575
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1013 Issued in SC
Practice address
1797 Main Rd
Johns Island, SC 29455-3447
Phone
(843) 559-7889
Fax
(843) 559-2355
NPI assigned
Mar 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1013 SC Primary

Addresses

Primary practice location

1797 Main Rd
Johns Island, SC 29455-3447

Mailing address

4600 Goer Dr Ste 210
North Charleston, SC 29406-6536
Phone (843) 744-5527

Other practice location 1

1245 Savannah Hwy
Charleston, SC 29407-7826
Phone (843) 766-5595

Other practice location 2

90 Spingview Lane Suite B
Summerville, SC 29485-2948
Phone (843) 875-2959

Other practice location 3

4600 Goer Dr Ste 210
North Charleston, SC 29406-6536
Phone (843) 744-5527

Other identifiers 1

IdentifierTypeStateIssuer
9189OtherSCPALMETTO GBA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL NorthCharleston Other

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

LicenseStateTypeSpecialty
1013SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Island P.T.,LLC Physical Therapist CurrentSince Jul 1, 2020 Accepting new patients
Carolina Orthopaedic and Neurosurgical Associates CurrentSince Sep 16, 2024 Accepting new patients
Carolina Orthopaedic and Neurosurgical Associates CurrentSince Sep 16, 2024 Accepting new patients

Locations

1245 Savannah Hwy
Charleston, SC 29407
Phone (843) 766-5595

220 Roper Mountain Road Ext
Greenville, SC 29615
Phone (864) 242-1163

1797 Main Rd
Johns Island, SC 29455
Phone (843) 559-5455

4600 Goer Dr
Ste 210
North Charleston, SC 29406
Phone (843) 744-5527

1330 Boiling Springs Rd
Ste 1600
Spartanburg, SC 29303
Phone (864) 582-6396

90 Springview Ln
#B
Summerville, SC 29485
Phone (843) 439-5311

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1584057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1841826575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 GOER DR STE 210",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294066536",
            "telephone_number": "843-744-5527",
            "fax_number": "843-746-9246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1797 MAIN RD",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294553447",
            "telephone_number": "843-559-7889",
            "fax_number": "843-559-2355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1245 Savannah Hwy",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294077826",
            "country_code": "US",
            "telephone_number": "843-766-5595",
            "fax_number": "843-766-5352",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "90 Spingview Lane Suite B",
            "address_purpose": "LOCATION",
            "city": "Summerville",
            "state": "SC",
            "postal_code": "294852948",
            "country_code": "US",
            "telephone_number": "843-875-2959",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4600 Goer Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "North Charleston",
            "state": "SC",
            "postal_code": "294066536",
            "country_code": "US",
            "telephone_number": "843-744-5527",
            "fax_number": "843-746-9246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLEMAN",
        "first_name": "JONATHAN",
        "middle_name": "MCKEY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-13",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "1013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "9189",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "NorthCharleston",
            "affiliation": "N",
            "endpointDescription": "MainOffice",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "North Charleston",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "North Charlesto",
            "address_1": "4600 Goer Dr Ste 210",
            "city": "North Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294066536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Johns Island, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.