Kirby L Scullion, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3495/T1636 Issued in OH

Practice address

4004 Tuscarawas St W
Canton, OH 44708-5503

Phone

(330) 479-9750

Fax

(330) 479-9752

NPI assigned

Aug 4, 2006

Sex

Male

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 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

Ohio State University - College of Optometry, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Ohio Professional PCGroup PAC ID 7618207036, 80 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 and National Provider Directory roles.

• Aeg Ohio Professional PC

  • Optometrist
  • Solon, OH
  • NPI 1154980811
  Medicare reassignment Care Compare group NPD
• Aeg Ohio Professional PC

  • Optometrist
  • Cincinnati, OH
  • NPI 1932708047
  NPD

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374278400000",
    "number": "1376551457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2379 17TH ST SE",
            "city": "EAST CANTON",
            "state": "OH",
            "postal_code": "447309542",
            "telephone_number": "330-452-1597",
            "fax_number": "330-479-9752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 TUSCARAWAS ST W",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447085503",
            "telephone_number": "330-479-9750",
            "fax_number": "330-479-9752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCULLION",
        "first_name": "KIRBY",
        "middle_name": "L",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2013-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3495/T1636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0442239",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melody K Scott
• Rebecca M Scott
• Richard Bernard Scott Jr.
• Scredon Meyer Enterprise LLC Dba Visiting Angels
• Katie Scrimo, LPC
• Kelly Scully, RD, LD
• Daniel Francis Scutella, DO
• Heidi Michele Seal, RRT
• Melissa J Sebille, CNP
• Courtney Seckinger, CT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.
• 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.