Michael Gerard Kelly, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1173 DT Issued in KY

Practice address

1578 Highway 44 E
Ste 7
Shepherdsville, KY 40165-7172

Phone

(502) 543-0646

Fax

(502) 543-0648

NPI assigned

Jul 7, 2006

Last updated

Jan 14, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Associates in Dermatology, PLLC

  • Dermatology Physician
  • Louisville, KY
  • NPI 1629083399
  NPD (past)
• Central Kentucky Optometric Associates PSC

  dba Uptown EyeCare

  • Optometrist
  • Shepherdsville, KY
  • NPI 1558558361
  NPD (past)
• East End Eye Care PLLC

  • Optometrist
  • Louisville, KY
  • NPI 1669855037
  NPD (past)
• Gaddie Eye Centers, LLC

  • Optometrist
  • Louisville, KY
  • NPI 1790759884
  NPD (past)
• Harry C Stephenson MD PLLC

  • Ophthalmology Physician
  • Louisville, KY
  • NPI 1578595112
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1154353134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1578 HIGHWAY 44 E",
            "address_2": "STE 7",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401657172",
            "telephone_number": "502-543-0646",
            "fax_number": "502-897-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1578 HIGHWAY 44 E",
            "address_2": "STE 7",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401657172",
            "telephone_number": "502-543-0646",
            "fax_number": "502-543-0648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MICHAEL",
        "middle_name": "GERARD",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1173 DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77011732",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Eastridge LLC (Diabetes Wellness and Healthcare)
• Kristin Kaster-Bratcher
• Christina Kayrouz, LCSW
• Kelly Kerr LLC
• Barbara G Kelly, MD
• Ken Hansen MD PSC
• Kentucky CVS Pharmacy LLC
• Kentucky Eye Care PSC
• Kentucky Support Community LLC
• Kelly Kerr

• Optometrist in Shepherdsville, KY
• Providers in Shepherdsville, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.