Active NPI
Tara Hollinshead
- Developmental Therapist
- Red Bud, IL
National Provider Identifier
1942651864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- License
- H45281288824
- Practice address
- 1125 Raymond Dr
Red Bud, IL 62278-1425 - Phone
- (618) 977-4261
- NPI assigned
- Jun 22, 2016
- Last updated
- Jun 22, 2016
- 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 |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | H45281288824 | IL | Primary |
Addresses
Primary practice location
1125 Raymond Dr
Red Bud, IL 62278-1425
Mailing address
1125 Raymond Dr
Red Bud, IL 62278-1425
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 |
|---|---|---|---|
| H45281288824 | IL | MD | Developmental Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466553600000",
"number": "1942651864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1125 RAYMOND DR",
"city": "RED BUD",
"state": "IL",
"postal_code": "622781425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1125 RAYMOND DR",
"city": "RED BUD",
"state": "IL",
"postal_code": "622781425",
"telephone_number": "618-977-4261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLINSHEAD",
"first_name": "TARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-22",
"last_updated": "2016-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "IL",
"license": "H45281288824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Red Bud, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.