Individual provider Active NPI

Kathleen V Holland, O.D.

  • Optometrist
  • Fayetteville, NC
National Provider Identifier
1790733384
Registry record updated Aug 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1567 Issued in NC
Practice address
4601 Ramsey St
Fayetteville, NC 28311-2138
Phone
(910) 488-4674
NPI assigned
May 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1567 NC Primary

Addresses

Primary practice location

4601 Ramsey St
Fayetteville, NC 28311-2138

Mailing address

317 Kimberwicke Dr
Fayetteville, NC 28311-7106
Phone (910) 630-0836

Other identifiers 1

IdentifierTypeStateIssuer
890904YMedicaidNC

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040210000631 NC Practitioner - Optometry 0042104119 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyecarecenter OD PAGroup PAC ID 7315834462, shared by 4 NPIs, 71 clinicians

Practice addresses (Care Compare)

113 Country Club Dr NE
Concord, NC 28025-2935
Phone (704) 786-7600

1669 Owen Dr
Fayetteville, NC 28304-3425
Phone (910) 323-3698

4140 Ramsey St
Fayetteville, NC 28311-7672
Phone (910) 488-0211

819 Tiffany Blvd
Rocky Mount, NC 27804-1812
Phone (252) 972-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1567NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecarecenter, O.D., P.a. Optometrist CurrentSince Sep 9, 2022 Accepting new patients
Eyecarecenter OD PA Optometrist Current Accepting new patients
Risk Optometric Associates, PA Optometrist CurrentSince Feb 1, 1996 Accepting new patients
Eyecarecenter OD PA Optometrist CurrentSince Sep 9, 2022 Accepting new patients
Eyecarecenter OD PA Optometrist CurrentSince Sep 9, 2022 Accepting new patients
The Eye Center, Doctors of Optometry, P.a. Optometrist Past Accepting new patients
Danny Keith Stamps Optometrist Past Accepting new patients
Eyecarecenter, O.D., P.a. Optometrist Past Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

1669 Owen Dr
Fayetteville, NC 28304
Phone (910) 323-3698

4140 Ramsey St
Ste 101
Fayetteville, NC 28311
Phone (910) 488-0211

4140 Ramsey St
Fayetteville, NC 28311
Phone (910) 488-0211

4601 Ramsey St
Fayetteville, NC 28311
Phone (910) 488-2828

819 Tiffany Blvd
Rocky Mount, NC 27804
Phone (252) 972-2020

3901 Oleander Dr
Wilmington, NC 28403
Phone (910) 395-2772

Interoperability endpoints

  • Direct secure messaging: kathleenholland@direct.eyecare-partners.com
  • Direct secure messaging: kathleen.holland@direct.revolutionehr.com

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280880000000",
    "number": "1790733384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 KIMBERWICKE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283117106",
            "telephone_number": "910-630-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 RAMSEY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283112138",
            "telephone_number": "910-488-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "KATHLEEN",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2010-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890904Y",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.