Individual provider Active NPI

Holly Melinda Williams, O.D.

  • Optometrist
  • Fayetteville, AR
National Provider Identifier
1982748851
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2565 Issued in AR
Practice address
2875 W 6TH St
Fayetteville, AR 72701
Phone
(479) 575-0328
NPI assigned
Feb 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2005020646 MO
Optometrist 152W00000X 2565 AR Primary

Addresses

Primary practice location

2875 W 6TH St
Fayetteville, AR 72701

Mailing address

PO Box 10618
Fayetteville, AR 72703-0045
Phone (918) 207-2413

Other names 1

  • Holly Melinda Holt Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20070906000045 AR Practitioner - Optometry 9133150832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martha Ellen Myers OD PAGroup PAC ID 1153305701, 2 clinicians

Practice addresses (Care Compare)

2875 W Martin Luther King Jr Blvd
Fayetteville, AR 72704-7625
Phone (479) 527-9790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2565ARMDOptometrist
2005020646MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Martha Ellen Myers, O.D. PA Optometrist CurrentSince May 8, 2007 Accepting new patients

Locations

2875 W Martin Luther King Jr Blvd
Fayetteville, AR 72704
Phone (479) 521-4350

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982748851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10618",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727030045",
            "telephone_number": "918-207-2413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 W 6TH ST",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72701",
            "telephone_number": "479-575-0328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "HOLLY",
        "middle_name": "MELINDA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2005020646",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "HOLT",
            "middle_name": "MELINDA",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.