Individual provider Active NPI

Paul W Holland, O.D.

  • Optometrist
  • Sierra Vista, AZ
National Provider Identifier
1427021914
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
525 Issued in AZ
Practice address
75 Colonia de Salud
#A100
Sierra Vista, AZ 85635-2487
Phone
(520) 459-6860
Fax
(520) 459-6858
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 525 AZ Primary

Addresses

Primary practice location

75 Colonia de Salud
#A100
Sierra Vista, AZ 85635-2487

Mailing address

2610 E University Dr
Mesa, AZ 85213-8436
Phone (480) 892-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1427021914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 E UNIVERSITY DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852138436",
            "telephone_number": "480-892-8400",
            "fax_number": "480-892-9533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 COLONIA DE SALUD",
            "address_2": "#A100",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352487",
            "telephone_number": "520-459-6860",
            "fax_number": "520-459-6858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "PAUL",
        "middle_name": "W",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; 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.