Individual provider Active NPI

David James Holler, O.D.

  • Optometrist
  • Apex, NC
National Provider Identifier
1184672859
Registry record updated Apr 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1711 Issued in NC
Practice address
1049 Beaver Creek Commons Dr
Apex, NC 27502-3918
Phone
(919) 367-7889
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1711 NC Primary

Addresses

Primary practice location

1049 Beaver Creek Commons Dr
Apex, NC 27502-3918

Mailing address

1049 Beaver Creek Commons Dr
Apex, NC 27502-3918
Phone (919) 367-7889

Other identifiers 2

IdentifierTypeStateIssuer
790903LMedicaidNC
0903LOtherNCBCBS PROV #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20051005001121 NC Practitioner - Optometry 3779517974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apex Vision Center OD PAGroup PAC ID 5193873560, 5 clinicians

Practice addresses (Care Compare)

1049 Beaver Creek Commons Dr
Apex, NC 27502-3918
Phone (919) 367-7889

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1711NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Vision Center OD PA Optometrist CurrentSince Feb 24, 2009 Accepting new patients
Myeyedr Optometry of North Carolina PLLC Optometrist Past Accepting new patients

Locations

1049 Beaver Creek Commons Dr
Apex, NC 27502
Phone (919) 367-2832

Organizations & group practices 2

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272412800000",
    "number": "1184672859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 BEAVER CREEK COMMONS DR",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275023918",
            "telephone_number": "919-367-7889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 BEAVER CREEK COMMONS DR",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275023918",
            "telephone_number": "919-367-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLER",
        "first_name": "DAVID",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2010-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "790903L",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROV #",
            "identifier": "0903L",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apex, NC

Sources for this page

Verify at the official NPI Registry.