Kenny Holloway Od PC
NPI 1417589664ActiveOrganization· Optometrist· Jasper, GA
Optometrist in Jasper, Georgia, registered in NPPES in February 2020. The authorized official on file is Kenny Holloway, OD, Ceo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1417589664 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 5, 2020 |
| Last updated in NPPES | Jan 19, 2023 |
| Certified by provider | Apr 12, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (GA) |
|---|
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