Donald I Holbrook, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

902DT Issued in KY

Practice address

21937 Main Street
PO DRW 778
Hyden, KY 41749-0778

Phone

(606) 672-2040

Fax

(606) 672-3937

NPI assigned

Sep 4, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Southeastern Eye Care Clinic

  • Optometrist
  • Hyden, KY
  • NPI 1851443394
  NPD (past)

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1376737320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21937 MAIN STREET",
            "address_2": "DRW 778",
            "city": "HYDEN",
            "state": "KY",
            "postal_code": "417490778",
            "telephone_number": "606-672-2040",
            "fax_number": "606-672-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21937 MAIN STREET",
            "address_2": "PO DRW 778",
            "city": "HYDEN",
            "state": "KY",
            "postal_code": "417490778",
            "telephone_number": "606-672-2040",
            "fax_number": "606-672-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBROOK",
        "first_name": "DONALD",
        "middle_name": "I",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "902DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77009025",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace Community Health Center, Inc.
• Tracey Angela Grigsby, MS, RD, LDN
• Marjorie Haas, M.D.
• Jessica Laise Hacker, PHARMD
• Nora C Hamlin, ARNP
• Hometown Pharmacy Inc.
• Hyden Emergency Physicians, LLC
• Hyden Nursing Home, LLC
• Deepu John, M.D.
• Diana Johnson-Whitaker

• All providers in Hyden, KY
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.