Active NPI
Mary Holm, OTR/L
- Occupational Therapist
- Albuquerque, NM
National Provider Identifier
1922588375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3490
- Practice address
- 6400 Uptown Blvd NE
Albuquerque, NM 87110-4202 - Phone
- (505) 855-9900
- NPI assigned
- Aug 15, 2018
- 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 | 3490 | NM | Primary |
Addresses
Primary practice location
6400 Uptown Blvd NE
Albuquerque, NM 87110-4202
Mailing address
6400 Uptown Blvd NE Ste 360
Albuquerque, NM 87110-4202
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3490 | NM | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534291200000",
"number": "1922588375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6400 UPTOWN BLVD NE STE 360",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871104202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6400 UPTOWN BLVD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871104202",
"telephone_number": "505-855-9900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLM",
"first_name": "MARY",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-15",
"last_updated": "2018-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "NM",
"license": "3490",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.