Individual provider Active NPI

Holli Purcell

  • Health & Wellness Coach
  • Palm Harbor, FL
National Provider Identifier
1912762931
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health & Wellness CoachTaxonomy code 171400000X
License
1210708675 Issued in FL
Practice address
3450 E Lake Rd Ste 307
Palm Harbor, FL 34685-2411
Phone
(727) 238-5821
NPI assigned
Feb 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 1190279787 FL
Health & Wellness Coach 171400000X 1210708675 FL Primary

Addresses

Primary practice location

3450 E Lake Rd Ste 307
Palm Harbor, FL 34685-2411

Mailing address

3450 E Lake Rd Ste 307
Palm Harbor, FL 34685-2411
Phone (727) 238-5821

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1210708675FLMDHealth & Wellness Coach
1190279787FLMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Revive to Thrive Therapies CurrentSince Feb 25, 2024 Accepting new patients

Locations

3450 E Lake Rd
Ste 307
Palm Harbor, FL 34685
Phone (727) 238-5821

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": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1912762931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 E LAKE RD STE 307",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346852411",
            "telephone_number": "727-238-5821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 E LAKE RD STE 307",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346852411",
            "telephone_number": "727-238-5821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURCELL",
        "first_name": "HOLLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-02-19",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "1190279787",
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "FL",
            "license": "1210708675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.