DR. BRADLY SHANE HOLLAND DO
NPI 1619905692
Family Medicine in Rogers, AR
About Dr. Bradly Shane Holland Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. BRADLY SHANE HOLLAND DO (NPI 1619905692) is an individual family medicine provider in Rogers, Arkansas, licensed in Arkansas (E-5111) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 2
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Bradly Shane Holland Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
5Medicare enrollment records show Bradly Holland reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Bentonville, AR 72712
- Reassigned Medicare billing, Arkansas enrollment
- 148 clinicians in this Medicare group
Gravette, AR 72736
- Reassigned Medicare billing, Arkansas enrollment
- 95 clinicians in this Medicare group
Magnolia, AR 71753
- Reassigned Medicare billing, Arkansas enrollment
- 106 clinicians in this Medicare group
Dallas, TX 75252
- Reassigned Medicare billing, Arkansas enrollment
- 130 clinicians in this Medicare group
Maysville, KY 41056
- Reassigned Medicare billing, Arkansas enrollment
- 310 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 72758 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Bradly Holland's NPI number?
The NPI number for Bradly Holland is 1619905692. It was assigned to this individual provider in the NPPES registry on June 29, 2006.
Where is Bradly Holland located?
Bradly Holland practices at 5208 W Village Pkwy Ste 1, Rogers, AR 72758. The listed phone number is (479) 389-2803.
What is Bradly Holland's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Bradly Holland enrolled in Medicare?
Yes. Bradly Holland is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Bradly Holland's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Bradly Holland reassigns Medicare benefits to 5 organizations: South Arkansas Emergency Physicians, LLP (Bentonville, AR), Sgoh Acquisition Inc (Gravette, AR), Hcc Of Magnolia LLC (Magnolia, AR), Emergency Staffing Solutions Region III (Dallas, TX) and Southeastern Emergency Physicians LLC (Maysville, KY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Bradly Holland's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Bradly Holland accept?
Health plans from Health Advantage and Octave list Bradly Holland as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Bradly Holland was last updated on July 31, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Bradly Shane Holland, DO · NPI 1619905692
Family Medicine physician in Rogers, Arkansas. Individual provider, active in the CMS NPPES registry since June 29, 2006.
## Identity
- **NPI:** 1619905692 (Entity type: Individual)
- **Enumerated:** June 29, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** E-5111 (Arkansas)
- **Sole proprietor:** No
## Practice location
- **Address:** 5208 W VILLAGE PKWY STE 1, Rogers, AR 72758-8199
- **Phone:** (479) 389-2803
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): South Arkansas Emergency Physicians, LLP (NPI 1447671490, Bentonville, AR); Sgoh Acquisition Inc (NPI 1568643005, Gravette, AR); Hcc Of Magnolia LLC (NPI 1831865872, Magnolia, AR); Emergency Staffing Solutions Region III (NPI 1689967895, Dallas, TX); Southeastern Emergency Physicians LLC (NPI 1356379382, Maysville, KY) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 31, 2024
- **Other identifiers:** Other 4119511 (TN); Medicaid 3300823 (TN)
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Source: [NPI Profile](https://npiprofile.com/npi/1619905692) · Data from the CMS NPPES public registry.