Active NPI
Larry Holle, O.D.
- Optometrist
- Phoenix, AZ
National Provider Identifier
1952413924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 102
- Practice address
- 11230 N Tatum Blvd
#100
Phoenix, AZ 85028-1663 - Phone
- (602) 263-0850
- Fax
- (602) 266-5490
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 102 | AZ | Primary |
Addresses
Primary practice location
11230 N Tatum Blvd
#100
Phoenix, AZ 85028-1663
Mailing address
11230 N Tatum Blvd
#100
Phoenix, AZ 85028-1663
Phone (602) 263-0850
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102 | AZ | MD | Optometrist |
| 714 | AZ | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holle & Holle Associates LLC | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355875200000",
"number": "1952413924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11230 N TATUM BLVD",
"address_2": "#100",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850281663",
"telephone_number": "602-263-0850",
"fax_number": "602-266-5490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11230 N TATUM BLVD",
"address_2": "#100",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850281663",
"telephone_number": "602-263-0850",
"fax_number": "602-266-5490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLE",
"first_name": "LARRY",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2012-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AZ",
"license": "102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.