NPIMap

Organization Active NPI

Holt Therapy and Wellness, PLLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • West Memphis, AR
National Provider Identifier
1891128260
Registry record updated Mar 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
License
PT1846 Issued in AR
Legal business name
HOLT THERAPY AND WELLNESS, PLLC
Practice address
310 Mid Continent PLZ Ste 185
West Memphis, AR 72301-1700
Phone
(870) 732-2828
Fax
(870) 732-1727
NPI assigned
Aug 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2015

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

Authorized official

Name
Mr. Kevin Dean Holt, M. S.NPI 1659704120
Title
Owner/Physical Therapist
Phone
(870) 732-2828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X PT1846 AR Primary

Addresses

Primary practice location

310 Mid Continent PLZ Ste 185
West Memphis, AR 72301-1700

Mailing address

310 Mid Continent PLZ Ste 185
West Memphis, AR 72301-1700
Phone (870) 732-2828

Other identifiers 4

IdentifierTypeStateIssuer
1891128260OtherARMEDI-PAK
1891128260OtherARHEALTH ADVANTAGE
1891128260OtherARBLUE CROSS BLUE SHIELD
1891128260OtherARUSABLE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150312002148 AR Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3375868862 Receives reassigned benefits from 8 practitioners
Practice locations: West Memphis, AR

National Provider Directory

National Provider Directory

Locations

310 Mid Continent Plz
Ste 185
West Memphis, AR 72301
Phone (870) 732-2828

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425340800000",
    "number": "1891128260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 MID CONTINENT PLZ STE 185",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723011700",
            "telephone_number": "870-732-2828",
            "fax_number": "870-732-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 MID CONTINENT PLZ STE 185",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723011700",
            "telephone_number": "870-732-2828",
            "fax_number": "870-732-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLT THERAPY AND WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-20",
        "last_updated": "2015-03-03",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "870-732-2828",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M. S."
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "AR",
            "license": "PT1846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-PAK",
            "identifier": "1891128260",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ADVANTAGE",
            "identifier": "1891128260",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1891128260",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USABLE",
            "identifier": "1891128260",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Memphis, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.