Individual provider Active NPI

Robert A Holloway Jr., M.D.

  • Ophthalmology Physician
  • Baton Rouge, LA
National Provider Identifier
1093877383
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
012008 Issued in LA
Practice address
4848 North Blvd
Baton Rouge, LA 70806-4019
Phone
(225) 927-0180
Fax
(225) 926-3803
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 012008 LA Primary

Addresses

Primary practice location

4848 North Blvd
Baton Rouge, LA 70806-4019

Mailing address

PO Box 66455
Baton Rouge, LA 70896-6455
Phone (225) 927-0180

Other identifiers 1

IdentifierTypeStateIssuer
1193640MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101122000682 LA Practitioner - Ophthalmology 9335335926 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
012008LAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baton Rouge Eye Physicians Ophthalmology CurrentSince Jan 1, 1979 Accepting new patients

Locations

4848 North Blvd
Baton Rouge, LA 70806
Phone (225) 927-0180

Organizations & group practices 1

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210032000000",
    "number": "1093877383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66455",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708966455",
            "telephone_number": "225-927-0180",
            "fax_number": "225-926-3803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4848 NORTH BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708064019",
            "telephone_number": "225-927-0180",
            "fax_number": "225-926-3803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2008-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "012008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1193640",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.