Iain M Kelly Sr., OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4207 Issued in OH

Practice address

3100 Governors Place Blvd
Kettering, OH 45409-1334

Phone

(937) 297-7676

NPI assigned

Jul 8, 2006

Last updated

Sep 21, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Warwar Eye Group IncGroup PAC ID 9335161231, 3 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Warwar Eye Group, Inc

  • Ophthalmology Physician
  • Kettering, OH
  • NPI 1134185994

  Optometrist

  Medicare reassignment Care Compare group NPD
• Ernst F. Fischer O.D., Inc.

  • Optometrist
  • Enon, OH
  • NPI 1619007085
  NPD (past)
• Todd McManus OD & Assoc Inc

  • Optometrist
  • Enon, OH
  • NPI 1447437132
  NPD (past)
• Warwar Eye Group

  • Eyewear Supplier
  • Kettering, OH
  • NPI 1851515423
  NPD (past)

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1366475014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33",
            "city": "MEDWAY",
            "state": "OH",
            "postal_code": "453410033",
            "telephone_number": "937-776-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 GOVERNORS PLACE BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454091334",
            "telephone_number": "937-297-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "IAIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riley Michelle Keeton
• Janny Lynn Kehr, CNP
• Brittney Frances Keller, FNP
• Michael D Kelley, PA
• Brennan L Kelly, PAC
• Maria Kelly, PA-C
• Samuel Joseph Keltner, MD
• Alyssa Kembre, PT, DPT
• Olivia Rose Kepner, MSN, FNP-BC
• Johnna K Kern, DO

• Optometrist in Kettering, OH
• Providers in Kettering, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.