Kelly C-K Tierney, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004430 Issued in MI

Practice address

4281 Lennon Rd
Flint, MI 48507-1024

Phone

(810) 720-9111

Fax

(810) 720-9119

NPI assigned

Aug 20, 2007

Last updated

Sep 26, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SVS Vision IncGroup PAC ID 9931257110, 41 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• SVS Vision Inc

  • Optometrist
  • Mount Clemens, MI
  • NPI 1194879023
  Medicare reassignment Care Compare group NPD
• Michigan Vision Institute PLLC

  dba Michigan Vision Institute

  • Ophthalmology Physician
  • Flint, MI
  • NPI 1780746081

  Optometrist

  Medicare reassignment NPD
• SVS Vision Inc

  dba SVS Vision 94

  • Optometrist
  • Mt Pleasant, MI
  • NPI 1558246942
  NPD
• Ohio Vision of Toledo Inc

  dba Optivue

  • Specialist
  • Oregon, OH
  • NPI 1528096203
  NPD (past)

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1073706578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4281 LENNON RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071024",
            "telephone_number": "810-720-9111",
            "fax_number": "810-720-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4281 LENNON RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071024",
            "telephone_number": "810-720-9111",
            "fax_number": "810-720-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIERNEY",
        "first_name": "KELLY",
        "middle_name": "C-K",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-20",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5725",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Thrushman, RD
• Alana J Thurlow, SOCIAL WORKER
• Andrea Jennae Thurlow, FNP-BC
• Michele L Tibbitt, MA, LLPC
• Jamie Tidswell
• Amber Tiggs
• Chavon Tiggs
• Daquane Tiggs
• Omecia Tiggs, CCMA
• Tina Marie Tiggs, BT

• Optometrist in Flint, MI
• Providers in Flint, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; 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.