Active NPI
Kelsey Kinn, OD
- Optometrist
- Indianapolis, IN
National Provider Identifier
1194396010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 18004324
- Practice address
- 6020 E 82ND St
Indianapolis, IN 46250-4746 - Phone
- (317) 841-0712
- NPI assigned
- Jul 2, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18004324 | IN | Primary |
Addresses
Primary practice location
6020 E 82ND St
Indianapolis, IN 46250-4746
Mailing address
6020 E 82ND St
Indianapolis, IN 46250-4746
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18004324 | IN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peak Visual Performance, LLC | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Optometrist
- Anderson, IN
- NPI 1932521580
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717545600000",
"number": "1194396010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6020 E 82ND ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462504746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6020 E 82ND ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462504746",
"telephone_number": "317-841-0712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINN",
"first_name": "KELSEY",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-02",
"last_updated": "2024-06-05",
"certification_date": "2024-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "18004324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.