Individual provider Active NPI

Dolores G Holland, OD

  • Optometrist
  • Indianapolis, IN
National Provider Identifier
1306987177
Registry record updated Dec 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002199B Issued in IN
Practice address
9745 Fall Creek Rd
400
Indianapolis, IN 46256-4728
Phone
(317) 578-0202
Fax
(317) 578-2696
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 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 18002199B IN Primary

Addresses

Primary practice location

9745 Fall Creek Rd
400
Indianapolis, IN 46256-4728

Mailing address

9745 Fall Creek Rd
400
Indianapolis, IN 46256-4728
Phone (317) 578-0202

Other names 1

  • Dolores G Holland Professional name

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
I20110121000281 IN Practitioner - Optometry 8123232113 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002199BINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Mar 9, 2020 Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Mar 9, 2020 Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist Current Accepting new patients

Locations

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

9745 Fall Creek Rd
Ste 400
Indianapolis, IN 46256
Phone (317) 578-0202

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291593600000",
    "number": "1306987177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9745 FALL CREEK RD",
            "address_2": "400",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462564728",
            "telephone_number": "317-578-0202",
            "fax_number": "317-578-2696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9745 FALL CREEK RD",
            "address_2": "400",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462564728",
            "telephone_number": "317-578-0202",
            "fax_number": "317-578-2696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "DOLORES",
        "middle_name": "G",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2010-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002199B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOLORES",
            "last_name": "HOLLAND",
            "middle_name": "G",
            "credential": "OD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.