NPIMap

Individual provider Active NPI

Savannah Merritt Huckaby, OD

  • Optometrist
  • Arkadelphia, AR
National Provider Identifier
1134867005
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2859 Issued in AR
Practice address
301 Professional Park Dr # a
Arkadelphia, AR 71923-5317
Phone
(870) 779-1022
Fax
(870) 568-0681
NPI assigned
May 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2859 AR Primary

Addresses

Primary practice location

301 Professional Park Dr # a
Arkadelphia, AR 71923-5317

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other names 1

  • Savannah Merritt Holman Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220728003723 AR Practitioner - Optometry 8820470446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Med Southwest PLLC 234 clinicians

Practice addresses (Care Compare)

301 Professional Park Dr
Suite a
Arkadelphia, AR 71923-5317
Phone (903) 838-0783

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2859ARMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Med Southwest, PLLC Optometrist CurrentSince Jul 18, 2022 Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Jul 18, 2022 Accepting new patients
Silver Spring Optometry, LLC Optometrist Past Accepting new patients

Locations

301 Professional Park Dr
#A
Arkadelphia, AR 71923
Phone (870) 246-5090

305 E Kiehl Ave
Sherwood, AR 72120
Phone (501) 753-1237

114 E 49th St
Texarkana, AR 71854
Phone (870) 774-2020

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1653091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1134867005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROFESSIONAL PARK DR # A",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719235317",
            "telephone_number": "870-779-1022",
            "fax_number": "870-568-0681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUCKABY",
        "first_name": "SAVANNAH",
        "middle_name": "MERRITT",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-21",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAVANNAH",
            "last_name": "HOLMAN",
            "middle_name": "MERRITT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Arkadelphia, AR

Sources for this page

Verify at the official NPI Registry.