Erik Joseph Kelly, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT003338 Issued in GA

Practice address

4900 Ivey Rd NW Ste 1226
Acworth, GA 30101-4108

Phone

(770) 974-3153

NPI assigned

Jul 9, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

A. Dylan Reach, OD, PCGroup PAC ID 9133252539, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• A. Dylan Reach, OD, PC

  • Optometrist
  • Acworth, GA
  • NPI 1205140126

  GA, Optometrist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1104497213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 IVEY RD NW STE 1226",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301014108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 IVEY RD NW STE 1226",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301014108",
            "telephone_number": "770-974-3153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ERIK",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-09",
        "last_updated": "2021-07-09",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delicia Julien, LPC
• Marquita Justice, RN
• Rachel Kabitzke, FNP-BC
• Brian Kase, LPC
• Kathmandu Dental LLC
• John I Kelly, D.C.
• Charles Perry Kemp, PHARMD
• Kourtney Kemp
• Gail Marie Kendall, PHARM.D. RPH
• Crystal Kennerly

• Optometrist in Acworth, GA
• Providers in Acworth, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; 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.