Michelle Renee Holt, LAT,ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT5708 Issued in TX

Practice address

3719 Pacific CT Apt 173
Benbrook, TX 76109-3977

Phone

(559) 816-7901

NPI assigned

Jan 29, 2014

Last updated

Jun 21, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Michelle Renee Vryhof Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1390953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1912320789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 RIVERFOREST COURT",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "76017",
            "telephone_number": "559-816-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3719 PACIFIC CT APT 173",
            "city": "BENBROOK",
            "state": "TX",
            "postal_code": "761093977",
            "telephone_number": "559-816-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "LAT,ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-29",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT5708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "VRYHOF",
            "middle_name": "RENEE",
            "credential": "LAT,ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Athletic Trainer in Benbrook, TX
• Providers in Benbrook, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.