Active NPI
Scott Robert Holman, P.T.
- Physical Therapist
- Orange, CA
National Provider Identifier
1952431306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT17509
- Practice address
- 871 S Tustin St
Orange, CA 92866-3426 - Phone
- (714) 633-7227
- Fax
- (714) 633-6092
- NPI assigned
- Mar 6, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT17509 | CA | Primary |
Addresses
Primary practice location
871 S Tustin St
Orange, CA 92866-3426
Mailing address
871 S Tustin St
Orange, CA 92866-3426
Phone (714) 633-7227
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT0175090 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT17509 | CA | MD | Physical Therapist |
| 17509 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952431306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "871 S TUSTIN ST",
"city": "ORANGE",
"state": "CA",
"postal_code": "928663426",
"telephone_number": "714-633-7227",
"fax_number": "714-633-6092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "871 S TUSTIN ST",
"city": "ORANGE",
"state": "CA",
"postal_code": "928663426",
"telephone_number": "714-633-7227",
"fax_number": "714-633-6092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMAN",
"first_name": "SCOTT",
"middle_name": "ROBERT",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT17509",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PT0175090",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.