Kellie Dawn Stennis, O.D., P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT1833 Issued in CO

Practice address

193 S 27TH Ave
Suite 400
Brighton, CO 80601-2661

Phone

(303) 654-7933

Fax

(303) 637-9002

NPI assigned

Nov 5, 2007

Sex

Female

Sole proprietor

Yes

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

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Wolf, OD PC

  • Optometrist
  • Brighton, CO
  • NPI 1235104233
  NPD

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383177600000",
    "number": "1225218530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 S 27TH AVE",
            "address_2": "SUITE 400",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806012661",
            "telephone_number": "303-654-7933",
            "fax_number": "303-637-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 S 27TH AVE",
            "address_2": "SUITE 400",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806012661",
            "telephone_number": "303-654-7933",
            "fax_number": "303-637-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STENNIS",
        "first_name": "KELLIE",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "O.D., P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-05",
        "last_updated": "2013-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT1833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "841381269",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Sprys, O.T.R.
• Aaron Stafford, M.D.
• Brandy Standard
• Chasity Lynn Starman, OTR
• Maggie Steinke
• Michelle K Stewart
• Tiffany Stewart, LPC
• Haley Stonebraker
• Vittoria Mary Strub
• Natasha Maria Summers, MA, CCC-SLP

• Optometrist in Brighton, CO
• Providers in Brighton, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.