Gordon R Kelly, MD
Individual provider Active NPI Ophthalmology Physician · Rutland, VT
NPI 1023082336 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1023082336
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Ophthalmology Physician 207W00000X
- License
- 0420004097 (VT)
- Practice address
- 254 Stratton Rd
Rutland, VT 05701 - Phone
- (802) 775-0038
- Fax
- (802) 747-0602
- NPI assigned
- Feb 14, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0420004097 | VT | MD | Ophthalmology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 0420004097 | VT | Yes |
Addresses
Primary practice location
254 Stratton Rd
Rutland, VT 05701
Mailing address
254 Stratton Rd
Gordon R Kelly MD
Rutland, VT 05701
Phone (802) 775-0038
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0004346 | Medicaid | VT |
Other providers in Rutland, VT
- Keene Medical Products, LLC
- Jason William Keicher
- William Daniel Kelley Jr.
- Laurel H Kelliher
- Carlton L. Kellogg
- Louise Anne Kenney
- Michael Kenosh
- Ali J Kenyon
- Christina Huth Keshava
- Praveen H. Keshava
All providers in Rutland, VT · Ophthalmology Physician in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.