Active NPI
Holly Marie Sandholm, OTR
- Occupational Therapist
- Champaign, IL
National Provider Identifier
1912150269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056006826
- Practice address
- 1315 Curt Dr
Champaign, IL 61821-1167 - Phone
- (217) 352-9334
- Fax
- (217) 352-9324
- NPI assigned
- Oct 30, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056006826 | IL | Primary |
Addresses
Primary practice location
1315 Curt Dr
Champaign, IL 61821-1167
Mailing address
3415 Waterville CT
Champaign, IL 61822-7417
Phone (217) 841-7230
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 |
|---|---|---|---|
| 056006826 | IL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Savoy Therapy Services Inc | Occupational 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371427200000",
"number": "1912150269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3415 WATERVILLE CT",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618227417",
"telephone_number": "217-841-7230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1315 CURT DR",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618211167",
"telephone_number": "217-352-9334",
"fax_number": "217-352-9324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDHOLM",
"first_name": "HOLLY",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-30",
"last_updated": "2013-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056006826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.