Individual provider Active NPI

Cameron James Holshouser, PT, DPT

  • Physical Therapist
  • Glendale, AZ
National Provider Identifier
1942859343
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-033461 Issued in AZ
Practice address
18561 N 59TH Ave Ste 117
Glendale, AZ 85308-1256
Phone
(602) 313-4089
NPI assigned
Sep 9, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305211907 VA
Physical Therapist 225100000X LPT-033461 AZ Primary

Addresses

Primary practice location

18561 N 59TH Ave Ste 117
Glendale, AZ 85308-1256

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Other practice location 1

1014 Clement St
Radford, VA 24141-2614
Phone (540) 605-9957

Other practice location 2

200 Patewood Dr Ste C150
Greenville, SC 29615-6323
Phone (864) 454-0904

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
12060SCMDPharmacist
LPT-033461AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings of Arizona, LLC Physical Therapist CurrentSince Sep 5, 2024 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Jan 3, 2022 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Jan 3, 2022 Accepting new patients
Greenville Proaxis Therapy LLC CurrentSince Sep 5, 2023 Accepting new patients
Greenville Proaxis Therapy, LLC Physical Therapist CurrentSince Sep 5, 2023 Accepting new patients
Ideal Rehabilitation LLC Past Accepting new patients
Prisma Health University Medical Group Past Accepting new patients

Locations

1485 E Florence Blvd
Ste 105
Casa Grande, AZ 85122
Phone (520) 494-3058

18561 N 59th Ave
Ste 117
Glendale, AZ 85308
Phone (602) 313-4089

11209 N Tatum Blvd
Ste B120
Phoenix, AZ 85028
Phone (602) 595-0204

1020 S Harrison Rd
Unit 120
Tucson, AZ 85748
Phone (520) 207-6288

790 Remington Blvd
Bolingbrook, IL 60440

33205 Collection Ctr Dr
Chicago, IL 60693

350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919

103 N Main St
Ste 201
Greenville, SC 29601
Phone (864) 528-5753

200 Patewood Dr
Ste C150
Greenville, SC 29615
Phone (864) 454-0904

10128 W Broad St
Bldg Iii
Glen Allen, VA 23060
Phone (804) 217-9210

12494 Warwick Blvd
Newport News, VA 23606
Phone (804) 217-9210

2033 Colonial Ave SW
Ste 138
Roanoke, VA 24015
Phone (540) 466-3981

Organizations & group practices 7

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": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1942859343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206",
            "fax_number": "517-435-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18561 N 59TH AVE STE 117",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081256",
            "telephone_number": "602-313-4089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1014 Clement St",
            "address_purpose": "LOCATION",
            "city": "Radford",
            "state": "VA",
            "postal_code": "241412614",
            "country_code": "US",
            "telephone_number": "540-605-9957",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Patewood Dr Ste C150",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296156323",
            "country_code": "US",
            "telephone_number": "864-454-0904",
            "fax_number": "864-454-0905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLSHOUSER",
        "first_name": "CAMERON",
        "middle_name": "JAMES",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-09",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305211907",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-033461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.