Individual provider Active NPI

Kelly Crews, OD

  • Optometrist
  • Norfolk, VA
National Provider Identifier
1295470672
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618003119 Issued in VA
Practice address
241 Corporate Blvd
Norfolk, VA 23502-4975
Phone
(970) 689-9585
NPI assigned
May 1, 2022
Last updated
Jun 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Optometrist 152W00000X 0618003119 VA Primary

Addresses

Primary practice location

241 Corporate Blvd
Norfolk, VA 23502-4975

Mailing address

3615 Rocky Stream Dr
Fort Collins, CO 80528-7173
Phone (970) 689-9585

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240112001465 CO Practitioner - Optometry 9335516442 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cheyenne Eye Clinic, LLC CurrentSince Jan 26, 2024 Accepting new patients
Eye Center of Northern Colorado, P.C Current Accepting new patients
Eye Center of Northern Colorado, P.C CurrentSince Jan 1, 2024 Accepting new patients
Eye Center Optical of Norther Colorado LLC Past Accepting new patients
Eye Center of Northern Colorado, P.C Optometrist PastSince Nov 13, 2022 Accepting new patients

Locations

4745 Arapahoe Ave
Ste 100
Boulder, CO 80303
Phone (303) 415-7000

101 Erie Pkwy
Ste 202
Erie, CO 80516
Phone (303) 444-3000

1725 E Prospect Rd
Fort Collins, CO 80525
Phone (970) 221-2222

1300 E 20th St
Cheyenne, WY 82001
Phone (307) 634-2020

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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": "1651363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1295470672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3615 ROCKY STREAM DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805287173",
            "telephone_number": "970-689-9585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 CORPORATE BLVD",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024975",
            "telephone_number": "970-689-9585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREWS",
        "first_name": "KELLY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-01",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618003119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.