Robert Lee Holly, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

162T Issued in WY

Practice address

1854 Dell Range Blvd
Cheyenne, WY 82009-4949

Phone

(307) 638-6610

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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.

• Eye Center of Northern Colorado, P.C.

  • Ophthalmology Physician
  • Fort Collins, CO
  • NPI 1073559605
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1689768699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1854 DELL RANGE BLVD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094949",
            "telephone_number": "307-638-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1854 DELL RANGE BLVD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094949",
            "telephone_number": "307-638-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLY",
        "first_name": "ROBERT",
        "middle_name": "LEE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WY",
            "license": "162T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106911000",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra J Holden, OTA
• Jasmine Holian
• Tierra Holland
• Jama Dawn Hollister
• James M Holloway Jr.
• Patricia Lynn Holmes, RN
• Wendy Holmes, RRT
• Brandy Holsendolph
• Erik Holt
• Sarah Marie Holt, PHARM.D.

• Optometrist in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Optometrist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; 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.