Individual provider Active NPI

Kelsey Ann Doering, OD

  • Optometrist
  • Massillon, OH
National Provider Identifier
1215448238
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6611 Issued in OH
Practice address
35 Erie St N Ste 110
Massillon, OH 44646-8451
Phone
(330) 880-0035
Fax
(330) 880-0034
NPI assigned
Oct 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6611 OH Primary

Addresses

Primary practice location

35 Erie St N Ste 110
Massillon, OH 44646-8451

Mailing address

35 Erie St N Ste 110
Massillon, OH 44646-8451
Phone (330) 880-0035

Other practice location 1

1249 Monroe St NW
New Philadelphia, OH 44663-4139
Phone (330) 364-2512

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ba Doering Eyecare LLC Optometrist CurrentSince Feb 21, 2021 Accepting new patients
Ba Doering Eyecare LLC Optometrist Current Accepting new patients
Dr Stein Optical Clinic Inc Optometrist Past Accepting new patients

Locations

35 Erie St N
Ste 110
Massillon, OH 44646
Phone (330) 880-0035

1249 Monroe St NW
New Philadelphia, OH 44663
Phone (330) 364-2512

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1215448238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 ERIE ST N STE 110",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446468451",
            "telephone_number": "330-880-0035",
            "fax_number": "330-880-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 ERIE ST N STE 110",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446468451",
            "telephone_number": "330-880-0035",
            "fax_number": "330-880-0034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1249 Monroe St NW",
            "address_purpose": "LOCATION",
            "city": "New Philadelphia",
            "state": "OH",
            "postal_code": "446634139",
            "country_code": "US",
            "telephone_number": "330-364-2512",
            "fax_number": "330-364-2078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOERING",
        "first_name": "KELSEY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-17",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massillon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.

Verify at the official NPI Registry.