Kellie London

Primary specialty

OptometristTaxonomy code 152W00000X

License

34770 Issued in CA

Practice address

3637 Larch Ave
South Lake Tahoe, CA 96150-7481

Phone

(530) 544-3403

NPI assigned

Feb 3, 2021

Last updated

Feb 3, 2021By 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 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Southern College of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ski Run Optometry by Dr. London, PC

  • Optometrist
  • S Lake Tahoe, CA
  • NPI 1558957589
  Medicare reassignment NPD Authorized official
• Truckee Family Eyecare Optometry, Inc

  dba Truckee Family Eyecare

  • Optometrist
  • Truckee, CA
  • NPI 1376262782
  Medicare reassignment NPD
• William a. Downey O.D. Inc

  • Optometrist
  • South Lake Tahoe, CA
  • NPI 1285779397
  NPD

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1134710932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3637 LARCH AVE",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507481",
            "telephone_number": "530-544-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3637 LARCH AVE",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507481",
            "telephone_number": "530-544-3403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONDON",
        "first_name": "KELLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.eyecloudpro.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3637 Larch Ave",
            "city": "South Lake Tahoe",
            "state": "CA",
            "country_code": "US",
            "postal_code": "961507481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Aaron M Lindsey, LCSW
• David M K I Liu, MD, PHD
• Live Violence Free (Vista Rise Collective)
• Miriam Locke, MD
• Lea Kathleen Logal
• Cherie Long, WHNP
• Longs Drug Stores California LLC (CVS Pharmacy #09713)
• Longs Drug Stores California LLC (CVS Pharmacy #09376)
• Catherine Lopez
• Rachel A Lowe

• Optometrist in South Lake Tahoe, CA
• Providers in South Lake Tahoe, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.