Individual provider Active NPI

Emma Holden, OD

  • Optometrist
  • Fayetteville, AR
National Provider Identifier
1083191555
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2787 Issued in AR
Practice address
2783 N Shiloh Dr
Fayetteville, AR 72704-6983
Phone
(479) 755-4510
NPI assigned
Jul 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Vision Optometrist 152WX0102X 2787 AR
Optometrist 152W00000X 2787 AR Primary

Addresses

Primary practice location

2783 N Shiloh Dr
Fayetteville, AR 72704-6983

Mailing address

665 N Samara Cir
Fayetteville, AR 72701-3035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181029000335 AR Practitioner - Optometry 3870846413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Triad Eye Institute PLLCGroup PAC ID 6507083557, 36 clinicians

Practice addresses (Care Compare)

2783 N Shiloh Dr
Fayetteville, AR 72704-6984
Phone (479) 442-8653

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Eye Institute PLLC Optometrist CurrentSince Aug 28, 2024 Accepting new patients
Triad Surgery Center LLC Past Accepting new patients
Triad Eye Institute PLLC Past Accepting new patients

Locations

1102 NW Lowes Ave
Ste 6
Bentonville, AR 72712
Phone (479) 442-8653

6140 S Memorial Dr
Tulsa, OK 74133
Phone (918) 252-2020

Interoperability endpoints

  • Direct secure messaging: eholden@triadeye.intellechartdirect.net

Organizations & group practices 3

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": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1083191555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 N SAMARA CIR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727013035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2783 N SHILOH DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727046983",
            "telephone_number": "479-755-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDEN",
        "first_name": "EMMA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-26",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "AR",
            "license": "2787",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.