Individual provider Active NPI

Melanie Renee McConnell Holtz, MPT

  • Physical Therapist
  • Evansville, IN
National Provider Identifier
1881736874
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05005845A Issued in IN
Practice address
958 S Kenmore Dr
Evansville, IN 47714-7513
Phone
(812) 477-5003
Fax
(812) 477-3639
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

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 05005845A IN Primary

Addresses

Primary practice location

958 S Kenmore Dr
Evansville, IN 47714-7513

Mailing address

958 S Kenmore Dr
Evansville, IN 47714-7513
Phone (812) 477-5003

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
05005845AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tieman Chiropractic and Rehabilitation LLC Physical Therapist PastSince Jun 10, 2002 Accepting new patients
Melanie R. McConnell Therapeutic Services, Inc. PastSince Feb 1, 2005 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.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193184000000",
    "number": "1881736874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "958 S KENMORE DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477147513",
            "telephone_number": "812-477-5003",
            "fax_number": "812-477-3639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "958 S KENMORE DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477147513",
            "telephone_number": "812-477-5003",
            "fax_number": "812-477-3639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNELL HOLTZ",
        "first_name": "MELANIE",
        "middle_name": "RENEE",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05005845A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.

Verify at the official NPI Registry.