Kenny Holloway OD PC
NPI 1417589664 · Optometrist · Jasper, GA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kenny Holloway OD PC is a Optometrist organization in Jasper, GA (NPI 1417589664).
Provider details
- NPI number
- 1417589664
- Entity type
- Organization
- Primary specialty
- OptometristEye and Vision Services Providers
- Organization subpart
- No
- Authorized official
- Kenny Holloway, Ceo(706) 692-5633
Specialties & taxonomies
Eye and Vision Services Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- The Eye Place
- Doing business as
- The Eye Place
Additional practice locations (1)
- 101 S River StCalhoun, GA 30701-2138Phone: (706) 629-4578Fax: (706) 629-0837
Registry dates
- Enumerated
- 2020-02-05
- Last updated
- 2023-01-19
- Certified
- 2021-04-12
Frequently asked questions
- What is Kenny Holloway OD PC's NPI number?
- Kenny Holloway OD PC's National Provider Identifier (NPI) is 1417589664, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Kenny Holloway OD PC?
- Kenny Holloway OD PC is classified in the NPPES registry as Optometrist (Eye and Vision Services Providers).
- Where is Kenny Holloway OD PC located?
- Kenny Holloway OD PC's practice location on file with NPPES is 105 N Main St Ste 100, Jasper, GA 30143-1557.
- What is Kenny Holloway OD PC's phone number?
- The practice phone number listed in the NPPES registry for Kenny Holloway OD PC is (678) 315-9446.
- Does Kenny Holloway OD PC accept Medicare?
- Kenny Holloway OD PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Kenny Holloway OD PC?
- The authorized official listed on Kenny Holloway OD PC's NPPES record is Kenny Holloway, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Kenny Holloway OD PC's NPI active?
- Yes — Kenny Holloway OD PC's NPI (1417589664) is active in the NPPES registry as of the last update on 2023-01-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.