Nicole L Holzbauer, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0668 Issued in SD

Practice address

501 W Havens Ave
Suite 103
Mitchell, SD 57301-4334

Phone

(605) 995-6044

Fax

(605) 995-6044

NPI assigned

Jul 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1932308798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1284",
            "address_2": "501 WEST HAVENS SUITE 103",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573017284",
            "telephone_number": "605-995-6044",
            "fax_number": "605-995-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W HAVENS AVE",
            "address_2": "SUITE 103",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573014334",
            "telephone_number": "605-995-6044",
            "fax_number": "605-995-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLZBAUER",
        "first_name": "NICOLE",
        "middle_name": "L",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SD",
            "license": "0668",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NE",
            "license": "1247",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Mitchell, SD
• Providers in Mitchell, SD by specialty
• Occupational Therapist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.