Individual provider Active NPI

Samantha Holland, OD

  • Optometrist
  • O Fallon, MO
National Provider Identifier
1992290886
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2018020969 Issued in MO
Practice address
3013 Winghaven Blvd
O Fallon, MO 63368-3600
Phone
(636) 561-3937
Fax
(636) 561-3937
NPI assigned
Jun 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2018020969 MO Primary

Addresses

Primary practice location

3013 Winghaven Blvd
O Fallon, MO 63368-3600

Mailing address

9979 Winghaven Blvd Ste 210
O Fallon, MO 63368-3628
Phone (636) 695-8555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20181113001628 MO Practitioner - Optometry 7810247459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Eyecare Associates IncGroup PAC ID 2961443395, 15 clinicians

Practice addresses (Care Compare)

3013 Winghaven Blvd
O Fallon, MO 63368-3600
Phone (636) 561-3937

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3455TNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carol P. Lagrange, O.D., P.C. Optometrist CurrentSince Jul 1, 2018 Accepting new patients
Regional Eyecare Associates Inc Optometrist CurrentSince May 5, 2020 Accepting new patients
Nto Denton, PLLC Optometrist Past Accepting new patients

Locations

402 W Washington St
Cuba, MO 65453
Phone (573) 885-2323

10640 Business 21
Hillsboro, MO 63050
Phone (636) 797-2330

10738 Business 21
Hillsboro, MO 63050
Phone (636) 543-2328

2681 Highway K
O Fallon, MO 63368
Phone (636) 978-5555

3013 Winghaven Blvd
O Fallon, MO 63368
Phone (636) 561-3937

9979 Winghaven Blvd
Ste 210
O Fallon, MO 63368

3758 Elm St
Saint Charles, MO 63301
Phone (636) 757-3553

4702 Mid Rivers Mall Dr
Saint Peters, MO 63376
Phone (636) 244-5378

3821 Veterans Memorial Pkwy
Saint Peters, MO 63376
Phone (636) 928-1111

853 Medical Dr
Ste 113
Wentzville, MO 63385
Phone (636) 327-8433

2043 Greystone Sq
Jackson, TN 38305
Phone (731) 668-3424

Organizations & group practices 3

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": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1992290886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9979 WINGHAVEN BLVD STE 210",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633683628",
            "telephone_number": "636-695-8555",
            "fax_number": "636-695-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3013 WINGHAVEN BLVD",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633683600",
            "telephone_number": "636-561-3937",
            "fax_number": "636-561-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "SAMANTHA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2018020969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

Verify at the official NPI Registry.