Douglas J. Kelley, Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

270A00507000 Issued in NJ

Legal business name

DOUGLAS J. KELLEY, INC.

Practice address

308 S New York Rd Unit D
Galloway, NJ 08205-9650

Phone

(609) 748-2288

Fax

(609) 748-8866

NPI assigned

Dec 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Douglas James Kelley, O.D.NPI 1962498345

Title

Optometrist

Phone

(609) 748-2288

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Douglas James Kelley, O.D.

  • Optometrist
  • Galloway, NJ
  • NPI 1962498345
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231459200000",
    "number": "1275715161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 S NEW YORK RD UNIT D",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059650",
            "telephone_number": "609-748-2288",
            "fax_number": "609-748-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 S NEW YORK RD UNIT D",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059650",
            "telephone_number": "609-748-2288",
            "fax_number": "609-748-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS J. KELLEY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2009-01-09",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "609-748-2288",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NJ",
            "license": "270A00507000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Dicesare-Bailey, LPC
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• Angela Marie Donato
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• Johanna Rose Durazzi, LSW
• Donna Pharo Dykes, PTA
• East Coast Chiropractic and Rehab Center
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• Eyewear Supplier in Galloway, NJ
• Providers in Galloway, NJ by specialty
• Eyewear Supplier in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.