Clifford L. Holt, O.D.,P.a.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1261-3 Issued in KS

Legal business name

CLIFFORD L. HOLT, O.D.,P.A.

Practice address

6435 Nieman Rd
Shawnee, KS 66203-3325

Phone

(913) 631-6959

Fax

(913) 631-5930

NPI assigned

Mar 20, 2012

Organization subpart

No

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

Authorized official

Name

Julie S. Holt

Title

Vice President

Phone

(913) 631-6959

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Locations

Practitioners 4

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

• Clifford L Holt, O.D.

  • Optometrist
  • Shawnee, KS
  • NPI 1144264235
  Medicare reassignment NPD
• Brandon Karl Hunter, O.D.

  • Optometrist
  • Leawood, KS
  • NPI 1306917810
  NPD (past)
• Chad E. Renner, O.D.

  • Optometrist
  • Olathe, KS
  • NPI 1841351426
  NPD (past)
• Sandra Vu

  • Optometrist
  • Shawnee, KS
  • NPI 1861981599
  NPD (past)

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333065600000",
    "number": "1013282268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6435 NIEMAN RD",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662033325",
            "telephone_number": "913-631-6959",
            "fax_number": "913-631-5930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6435 NIEMAN RD",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662033325",
            "telephone_number": "913-631-6959",
            "fax_number": "913-631-5930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFFORD L. HOLT, O.D.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-20",
        "last_updated": "2012-03-30",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "913-631-6959"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1261-3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100218370C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tina M Clark, LSCSW
• Tracy A Clark, ARNP
• Tucker Clark
• Barbara Gaye Cleverdon, LCMFT
• Clifford L. Holt, O.D.
• Perry L Cobb, RPH
• Karinne Coberly
• Kristina D Cockerill
• Seth Cohen, DDS
• Michelle C. Coker, PH.D.

• Optometrist in Shawnee, KS
• Providers in Shawnee, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.