Individual provider Active NPI

Holly Snow Coriell, O.D.

  • Optometrist
  • Indianapolis, IN
National Provider Identifier
1205927068
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003436A Issued in IN
Practice address
6020 Crawfordsville Rd Ste 102
Indianapolis, IN 46224-3710
Phone
(317) 957-2070
NPI assigned
Sep 27, 2006
Last updated
Mar 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18003436A IN Primary

Addresses

Primary practice location

6020 Crawfordsville Rd Ste 102
Indianapolis, IN 46224-3710

Mailing address

3403 E Raymond St
Indianapolis, IN 46203-4744
Phone (317) 957-2000

Other identifiers 1

IdentifierTypeStateIssuer
200841970MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20071204000656 IN Practitioner - Optometry 0244329803 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2000
Medicare assignment
May accept Medicare assignment
Group practices
Healthnet IncGroup PAC ID 7214840933, 77 clinicians

Practice addresses (Care Compare)

2855 N Keystone Ave
Suite 120
Indianapolis, IN 46218-2790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001849GAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Indiana, LLC Optometrist Current Accepting new patients
Healthnet, Inc. CurrentSince Jan 8, 2024 Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Jun 24, 2019 Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Jun 24, 2019 Accepting new patients

Locations

14555 Hazel Dell Pkwy
Ste 120
Carmel, IN 46033
Phone (317) 706-2020

9760 Lantern Rd
Fishers, IN 46037
Phone (317) 577-9200

1522 W Morris St
Indianapolis, IN 46221
Phone (317) 488-2020

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

2340 E 10th St
Indianapolis, IN 46201
Phone (317) 633-7360

2855 N Keystone Ave
Ste 130
Indianapolis, IN 46218

3401 E Raymond St
Indianapolis, IN 46203
Phone (317) 788-9769

3401 E Raymond St
#0
Indianapolis, IN 46203

3403 E Raymond St
Indianapolis, IN 46203
Phone (317) 957-2000

3403 E Raymond St
Ste A
Indianapolis, IN 46203
Phone (317) 957-2070

901 Shelby St
Indianapolis, IN 46203
Phone (317) 488-2040

6020 Crawfordsville Rd
Ste 102
Speedway, IN 46224
Phone (317) 957-2070

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1205927068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3403 E RAYMOND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462034744",
            "telephone_number": "317-957-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 CRAWFORDSVILLE RD STE 102",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462243710",
            "telephone_number": "317-957-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORIELL",
        "first_name": "HOLLY",
        "middle_name": "SNOW",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003436A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200841970",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.