Individual provider Active NPI

Joe Chaddrick Kea, O.D.

  • Optometrist
  • Tupelo, MS
National Provider Identifier
1053404012
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
578PY Issued in MS
Practice address
3437 Tupelo Commons
Suite 101
Tupelo, MS 38804-9791
Phone
(662) 842-2000
Fax
(662) 842-0379
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 578PY MS Primary

Addresses

Primary practice location

3437 Tupelo Commons
Suite 101
Tupelo, MS 38804-9791

Mailing address

3437 Tupelo CMNS Ste 101
Tupelo, MS 38804-9791
Phone (662) 231-1895

Other identifiers 1

IdentifierTypeStateIssuer
00880031MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20040429000065 MS Practitioner - Optometry 4082601265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3437 Tupelo CMNS
Suite 101
Tupelo, MS 38804-9791
Phone (662) 842-2000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
578PYMSMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Care, Inc. Optometrist CurrentSince Aug 1, 1992 Accepting new patients

Locations

3437 Tupelo Commons
Ste 101
Tupelo, MS 38804
Phone (662) 842-2000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1053404012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3437 TUPELO CMNS STE 101",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388049791",
            "telephone_number": "662-231-1895",
            "fax_number": "662-842-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3437 TUPELO COMMONS",
            "address_2": "SUITE 101",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388049791",
            "telephone_number": "662-842-2000",
            "fax_number": "662-842-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEA",
        "first_name": "JOE",
        "middle_name": "CHADDRICK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "578PY",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00880031",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.