Holland Eye Clinic, P.a.

Organization Active NPI Optometrist · Oskaloosa, KS

NPI 1003964032 · NPPES record last updated Jul 6, 2010

Key facts

NPI
1003964032
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
License
1530CHARLES1446JNETT (KS)
Legal business name
HOLLAND EYE CLINIC, P.A.
Practice address
1106 Walnut St
Oskaloosa, KS 66066-4203
Phone
(785) 863-2000
Fax
(785) 863-3333
NPI assigned
Jan 8, 2007
Organization subpart
No

Authorized official

Name
Dr. Jeannette Lorraine Holland, O.D.
Title
President
Phone
(785) 863-2000

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Holland Eye Clinic PA
1106 Walnut St, Oskaloosa, KS 66066-4203 · (785) 863-2000
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignment
Participating since Jan 1, 1999

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in KS

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080701000009 KS Part B Supplier - Clinic/Group Practice 9234201666 Receives reassigned benefits from 2 practitioners
Practice locations: Basehor, KS; Oskaloosa, KS
O20100930091304 KS DME Supplier - Physician - Optometrist 9234201666 Practice locations: Oskaloosa, KS

National Provider Directory

Locations

15330 Wolfcreek Pkwy
Basehor, KS 66007

15330 Wolfcreek Pkwy
Ste 300
Basehor, KS 66007
Phone (913) 724-0700

1106 Walnut St
Oskaloosa, KS 66066
Phone (785) 863-2000

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP
152W00000X 1530CHARLES1446JNETT KS Yes

Addresses

Primary practice location

1106 Walnut St
Oskaloosa, KS 66066-4203

Mailing address

1106 Walnut St
Oskaloosa, KS 66066-4203
Phone (785) 863-2000

Other identifiers

IdentifierTypeStateIssuer
1003964032OtherKSGROUP NPI
1134294549OtherKSNPI CHARLES
1225072341OtherKSNPI JEANNETTE
1003964032MedicaidKS

Other providers in Oskaloosa, KS

All providers in Oskaloosa, KS · Optometrist in Kansas

Sources for this page

Verify at the official NPI Registry.