Individual provider Active NPI

Kelsea Brown, OD

  • Optometrist
  • Atlanta, GA
National Provider Identifier
1447850466
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003298 Issued in GA
Practice address
2184 Henderson Mill Rd NE Ste 12B
Atlanta, GA 30345-3762
Phone
(770) 938-2923
NPI assigned
Oct 28, 2020
Last updated
Jun 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003298 GA Primary

Addresses

Primary practice location

2184 Henderson Mill Rd NE Ste 12B
Atlanta, GA 30345-3762

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20201201000761 GA Practitioner - Optometry 6608287321 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Georgia, LLCGroup PAC ID 8224261201, 100 clinicians

Practice addresses (Care Compare)

2184 Henderson Mill Rd NE
Atlanta, GA 30345-3762
Phone (770) 938-2923

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT003298GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Nov 23, 2020 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Nov 23, 2020 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Current Accepting new patients
Cindy J Stewart PC Optometrist PastSince Nov 1, 2020 Accepting new patients

Locations

2184 Henderson Mill Rd NE
Atlanta, GA 30345
Phone (770) 938-2923

2184 Henderson Mill Rd NE
Ste 12B
Atlanta, GA 30345
Phone (770) 491-1255

4875 Altama Ave
Brunswick, GA 31520
Phone (912) 554-0010

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

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.

NPI Registry JSON

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1447850466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2184 HENDERSON MILL RD NE STE 12B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303453762",
            "telephone_number": "770-938-2923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KELSEA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-28",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.