Beverly A Holdeman, L.M.T., M.M.P.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT 05786 Issued in AZ

Practice address

4212 W Creedance Blvd
Glendale, AZ 85310-4072

Phone

(623) 780-7598

NPI assigned

Oct 21, 2008

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 identifiers 2

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": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224547200000",
    "number": "1922250083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4212 W CREEDANCE BLVD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853104072",
            "telephone_number": "623-780-7598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 W CREEDANCE BLVD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853104072",
            "telephone_number": "623-780-7598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDEMAN",
        "first_name": "BEVERLY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "L.M.T., M.M.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2008-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AZ",
            "license": "MT 05786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED MASSAGE THERAPIST",
            "identifier": "MT 05786",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL CERTIFICATION BOARD OF THERAPEUTIC MASSAGE AND BODYWORK",
            "identifier": "448408 00",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hoftb Anesthesia LLC
• Patrick William Hogan, D.O.
• Linda Joann Hogg, RD, LN
• Vahid Hojreh, D.M.D
• Windy Lalone Hokanson-Foust, D.C.
• Julie Holdridge, SLP
• Sheri Holemon, PAC
• Patsy Holguin, LPN
• Kurt Adam Holifield, FNP-C
• Holistic Healing Center LLC

• Massage Therapist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Massage Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; 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.