Active NPI
Kelly Patrick Dice, O.D.
- Optometrist
- Clarksville, IN
National Provider Identifier
1508813270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 18003479A
- Practice address
- 207 E Lewis and Clark Pkwy
Clarksville, IN 47129-1711 - Phone
- (812) 945-2573
- Fax
- (812) 945-2536
- NPI assigned
- May 28, 2006
- Last updated
- Aug 18, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18003479A | IN | Primary |
Addresses
Primary practice location
207 E Lewis and Clark Pkwy
Clarksville, IN 47129-1711
Mailing address
207 E Lewis and Clark Pkwy
Clarksville, IN 47129-1711
Phone (812) 945-2573
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- 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
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
207 E Lewis and Clark Pkwy
Clarksville, IN 47129-1711
Phone (812) 945-2573
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18003479A | IN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Visionary Eyecare LLC | Optometrist | Current | Accepting new patients |
| Optometry Group | Optometrist | Past | Accepting new patients |
Locations
207 E Lewis and Clark Pkwy
Clarksville, IN 47129
Phone (812) 945-2573
Organizations & group practices 2
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.
-
- Optometrist
- Memphis, TN
- NPI 1871548107
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250553600000",
"number": "1508813270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 E LEWIS AND CLARK PKWY",
"city": "CLARKSVILLE",
"state": "IN",
"postal_code": "471291711",
"telephone_number": "812-945-2573",
"fax_number": "812-945-2536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 E LEWIS AND CLARK PKWY",
"city": "CLARKSVILLE",
"state": "IN",
"postal_code": "471291711",
"telephone_number": "812-945-2573",
"fax_number": "812-945-2536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICE",
"first_name": "KELLY",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-28",
"last_updated": "2009-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "18003479A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, IN
- Isabella Degeorge
- Maeghan Dennison
- Dental Professionals of Indiana, P.C. (Dentistry Plus - Clarksville)
- Derby Mobile Vision Care LLC
- Madison Dibble, RBT
- Katlyn H Digges, RBT
- Douglas Anthony Dixon, LMHC
- Bonnie Sue Doan, MSSW, LCSW
- Abigail Regan Donaway, CF-SLP
- Dr Mark Lynn & Associates PLLC (Visionworks Doctors of Optometry)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; 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.