Shawn M Kelly, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

5621TG Issued in TX

Practice address

2313 W Parker Rd
Plano, TX 75023-7839

Phone

(972) 612-2015

Fax

(972) 867-5454

NPI assigned

Aug 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Med Southwest PLLCGroup PAC ID 4082952874, 234 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• TX HMO D-SNP
• TX HMO
• NM HMO C-SNP

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.

• Med Southwest, PLLC

  • Optometrist
  • Houston, TX
  • NPI 1609348739
  Medicare reassignment Care Compare group NPD
• Med Southwest, PLLC

  • Optometrist
  • Plano, TX
  • NPI 1164067294
  NPD
• Med Southwest, PLLC

  • Optometrist
  • Oklahoma City, OK
  • NPI 1679440762
  NPD
• Silver Spring Optometry, LLC

  • Optometrist
  • Silver Spring, MD
  • NPI 1336204387
  NPD (past)

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256688000000",
    "number": "1003808395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2313 W PARKER RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750237839",
            "telephone_number": "972-612-2015",
            "fax_number": "972-867-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2313 W PARKER RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750237839",
            "telephone_number": "972-612-2015",
            "fax_number": "972-867-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SHAWN",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2009-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2689",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5621TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410049426",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelli Watkins MD PA
• Michael Joseph Kelly-Sell, MD
• Ashley Kelly
• Emily Kelly, LPC-ASSOCIATE
• Madeline Kelly, AUD
• Sherry Ann Kelly, LCSW
• Kristen Rene Kemp, RD
• Tye J Kemp, MS, LPC
• James Ken, M.D.
• Kendall M. Jones MD PA

• Optometrist in Plano, TX
• Providers in Plano, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.