Active NPI
Kelly Ann Durst-Sharpe, O.D.
- Optometrist
- Quincy, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046011066
- Practice address
- 1125 Hampshire St
Quincy, IL 62301-3026 - Phone
- (217) 222-6550
- Fax
- (217) 277-2253
- NPI assigned
- Jun 18, 2015
- Last updated
- Mar 17, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2015019033 | MO | |
| Optometrist | 152W00000X | 046011066 | IL | Primary |
Addresses
Primary practice location
1125 Hampshire St
Quincy, IL 62301-3026
Mailing address
1025 Maine St
Quincy, IL 62301-4038
Phone (217) 222-6550
Other practice location 1
1702 N Baltimore St
Kirksville, MO 63501-2485
Phone (660) 665-6262
Other practice location 2
1702 N Baltimore St
Kirksville, MO 63501-2485
Phone (660) 665-6262
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of Missouri St Louis - School of Optometry, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1125 Hampshire St
Quincy, IL 62301-3026
Phone (217) 222-6550
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046011066 | IL | MD | Optometrist |
| 2015019033 | MO | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Luke's Methodist Hospital | Current | Accepting new patients | |
| Quincy Physicians & Surgeons Clinic, PLLC | Current | Accepting new patients | |
| Quincy Physicians & Surgeons Clinic, PLLC | Current | Accepting new patients | |
| Quincy Physicians & Surgeons Clinic, PLLC | Current | Accepting new patients |
Locations
1025 Maine St
Quincy, IL 62301
Phone 21722265503163
1125 Hampshire St
Quincy, IL 62301
Phone (217) 222-3937
Interoperability endpoints
- kdurstsharpe600558@direct.unitypoint.org
Organizations & group practices 4
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.
-
- Clinic/Center
- Quincy, IL
- NPI 1548234198
-
dba Quincy Medical Group Mt. Sterling Affiliate
- Rural Health Clinic/Center
- Mt Sterling, IL
- NPI 1649244187
-
- Durable Medical Equipment & Medical Supplies
- Pittsfield, IL
- NPI 1871794925
-
- General Acute Care Hospital
- Cedar Rapids, IA
- NPI 1083708226
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1447632187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 MAINE ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623014038",
"telephone_number": "217-222-6550",
"fax_number": "217-277-2253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1125 HAMPSHIRE ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623013026",
"telephone_number": "217-222-6550",
"fax_number": "217-277-2253"
}
],
"practiceLocations": [
{
"address_1": "1702 N Baltimore St",
"address_purpose": "LOCATION",
"city": "Kirksville",
"state": "MO",
"postal_code": "635012485",
"country_code": "US",
"telephone_number": "660-665-6262",
"fax_number": "660-665-5908",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1702 N Baltimore St",
"address_purpose": "LOCATION",
"city": "Kirksville",
"state": "MO",
"postal_code": "635012485",
"country_code": "US",
"telephone_number": "660-665-6262",
"fax_number": "660-665-5908",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DURST-SHARPE",
"first_name": "KELLY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-18",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "2015019033",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046011066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Quincy, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.