Individual provider Active NPI

Larry Array Hollar Jr., M.D.

  • Family Medicine Physician
  • Mocksville, NC
National Provider Identifier
1417038738
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
98-00910 Issued in NC
Practice address
1188 Yadkinville Rd
Mocksville, NC 27028-2037
Phone
(367) 167-4353
Fax
(336) 702-9277
NPI assigned
Oct 17, 2006
Last updated
Oct 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 98-00910 NC Primary

Addresses

Primary practice location

1188 Yadkinville Rd
Mocksville, NC 27028-2037

Mailing address

Provider Enrollment
100 Kimel Forest Drive
Winston Salem, NC 27103-6074
Phone (336) 713-0947

Other identifiers 2

IdentifierTypeStateIssuer
127R4OtherNCBLUE CROSS BLUE SHIELD
89127R4MedicaidNC

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040504001603 NC Practitioner - Family Practice 4981697323 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wake Forest University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1188 Yadkinville Rd
Mocksville, NC 27028-2037
Phone (336) 753-1555

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
98-00910NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Aug 7, 2023 Accepting new patients
Forsyth Memorial Hospital, Inc. Family Medicine Current Accepting new patients
Novant Health Medical Group, LLC Family Medicine CurrentSince Jul 1, 2019 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 1, 2019 Accepting new patients
Forsyth Memorial Hospital Inc Family Medicine CurrentSince Aug 1, 2007 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Aug 1, 2007 Accepting new patients

Locations

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

2311 Lewisville Clemmons Rd
Fl 3
Clemmons, NC 27012
Phone (336) 713-8900

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

1188 Yadkinville Rd
Mocksville, NC 27028
Phone (336) 716-7435

1038 Bethania Rural Hall Rd
Rural Hall, NC 27045
Phone (336) 716-9270

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

105 Vest Mill Cir
Winston Salem, NC 27103
Phone (336) 718-7800

1381 Westgate Center Dr
Winston Salem, NC 27103
Phone (336) 718-0100

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

3333 Brookview Hills Blvd
Ste 201
Winston Salem, NC 27103
Phone (336) 602-2801

390 W Salem Ave
Winston Salem, NC 27101
Phone (336) 721-2375

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: lhollar2792131@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1417038738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PROVIDER ENROLLMENT",
            "address_2": "100 KIMEL FOREST DRIVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-713-0947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1188 YADKINVILLE RD",
            "city": "MOCKSVILLE",
            "state": "NC",
            "postal_code": "270282037",
            "telephone_number": "367-167-4353",
            "fax_number": "336-702-9277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAR",
        "first_name": "LARRY",
        "middle_name": "ARRAY",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-10-23",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "98-00910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "127R4",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89127R4",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mocksville, NC

Sources for this page

Verify at the official NPI Registry.