Active NPI
Joe Chaddrick Kea, O.D.
- Optometrist
- Tupelo, MS
National Provider Identifier
1053404012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 578PY
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00880031 | Medicaid | MS |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 13 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 578PY | MS | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vision Care, Inc. | Optometrist | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; 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.