Kelley Lynn Deak, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18002969A Issued in IN

Practice address

1980 N National Rd Ste 300
Columbus, IN 47201-4505

Phone

(317) 202-1438

Fax

(317) 202-1280

NPI assigned

Sep 11, 2006

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

Other identifiers 2

Other names 1

• Kelley Lynn Douglas Former name

Medicare fee-for-service enrollment

Enrolled in IN

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

Indiana University - School of Optometry, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seymour Eye Clinic LLCGroup PAC ID 2668503418, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelley.deak@direct.revolutionehr.com

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.

• Seymour Eye Clinic LLC

  • Optometrist
  • Seymour, IN
  • NPI 1730165267
  Medicare reassignment Care Compare group
• Precision Eye Group P.C.

  • Optometrist
  • Bedford, IN
  • NPI 1558523886
  Medicare reassignment NPD
• Wilson Eyecare Professionals PC

  • Optometrist
  • Greenfield, IN
  • NPI 1669755575
  Medicare reassignment NPD
• Union Optical and Eyecare Center, Inc.

  • Eyewear Supplier
  • Bedford, IN
  • NPI 1871743716

  Optometrist

  NPD
• Columbus Optical Service Inc.

  • Optician
  • Columbus, IN
  • NPI 1548330160
  NPD (past)
• Eye Associates of Southern Indiana PC

  • Durable Medical Equipment & Medical Supplies
  • New Albany, IN
  • NPI 1083607592

  Optometrist

  NPD (past)
• Michael D. Mangas, O.D., P.C.

  • Optometrist
  • Columbus, IN
  • NPI 1376605816
  NPD (past)
• Olinger and Larkin PTR

  • Optometrist
  • Columbus, IN
  • NPI 1407028137
  NPD (past)

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1184728123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1980 N NATIONAL RD STE 300",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472014505",
            "telephone_number": "317-202-1438",
            "fax_number": "317-202-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1980 N NATIONAL RD STE 300",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472014505",
            "telephone_number": "317-202-1438",
            "fax_number": "317-202-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAK",
        "first_name": "KELLEY",
        "middle_name": "LYNN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-11",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002969A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201006850",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "A00845",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEY",
            "last_name": "DOUGLAS",
            "middle_name": "LYNN",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ronald Scott Davis, DDS
• Jennifer Dawson
• Darrell L Day, D.C.
• Joseph Andrew Day, MD
• Nancy E. Dayhoff, R.N.
• Sean Deak
• Jordan Dean, PA
• Walter H Dearmitt, MD
• Elizabeth Rose Deaton, RN
• Lillian Deaton, RBT

• Optometrist in Columbus, IN
• Providers in Columbus, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.

Verify at the official NPI Registry.