Kelli Bruce, OD
Individual provider Active NPI Optometrist · Newport, KY
NPI 1457039737 · NPPES record last updated Jul 7, 2023
Key facts
- NPI
- 1457039737
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2347DT (KY)
- Practice address
- 59 Carothers Rd
Newport, KY 41071-2415 - Phone
- (859) 491-1010
- NPI assigned
- Jul 7, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 2023
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Opticare Vision Centers, LLC
DRS Cooke, Landon and Sellers Optometrist, P.S.C
Practice addresses (Care Compare)
2220 Grandview Dr
Suite 120
Fort Mitchell, KY 41017-1691
Phone (859) 578-0393
59 Carothers Rd
Newport, KY 41071-2415
Phone (859) 491-1010
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230728003257 | KY | Practitioner - Optometry | 0244691848 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2347DT | KY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Opticare Vision Centers, LLC | Optometrist | Current |
Accepting new patients |
| DRS Cooke, Landon & Sellers, Optometrist, P.S.C | Optometrist | Current |
Accepting new patients |
Locations
6901 Dixie Hwy
Florence, KY 41042
Phone (859) 525-1800
2220 Grandview Dr
Ste 120
Ft Mitchell, KY 41017
Phone (859) 578-0393
59 Carothers Rd
Newport, KY 41071
Phone (859) 491-1010
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2347DT | KY | Yes |
Addresses
Primary practice location
59 Carothers Rd
Newport, KY 41071-2415
Mailing address
59 Carothers Rd
Newport, KY 41071-2415
Phone (859) 491-1010
Other providers in Newport, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.