NPIMap

Organization Active NPI

Eye Care Clinic & Optical LLC

  • Eyewear Supplier
  • Cheyenne, WY
National Provider Identifier
1427265180
Registry record updated Sep 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
EYE CARE CLINIC & OPTICAL LLC
Practice address
6228 Yellowstone Rd
Cheyenne, WY 82009-3432
Phone
(307) 778-2771
Fax
(307) 634-5443
NPI assigned
May 16, 2007
Last updated
Sep 3, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2015

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

Authorized official

Name
Dr. Robert Lee Holly, OD
Title
Managing Partner
Phone
(307) 778-2771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

6228 Yellowstone Rd
Cheyenne, WY 82009-3432

Mailing address

6228 Yellowstone Rd
Cheyenne, WY 82009-3432
Phone (307) 778-2771

Other identifiers 1

IdentifierTypeStateIssuer
106507600MedicaidWY

National Provider Directory

National Provider Directory

Locations

6228 Yellowstone Rd
Cheyenne, WY 82009
Phone (307) 634-3894

6252 Yellowstone Rd
Cheyenne, WY 82009
Phone (307) 778-2015

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441238400000",
    "number": "1427265180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6228 YELLOWSTONE RD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820093432",
            "telephone_number": "307-778-2771",
            "fax_number": "307-634-5443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6228 YELLOWSTONE RD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820093432",
            "telephone_number": "307-778-2771",
            "fax_number": "307-634-5443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE CLINIC & OPTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2015-09-03",
        "status": "A",
        "authorized_official_last_name": "HOLLY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "307-778-2771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106507600",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; 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.