Kelly A Martin, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2504 Issued in TN

Practice address

600 E Veterans Dr Ste a
Cookeville, TN 38501-4038

Phone

(931) 372-1994

NPI assigned

Jun 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Kelly A Sanderson Former name

Medicare fee-for-service enrollment

Enrolled in TN

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

Merit-based Incentive Payment System (MIPS)

Final score

79.98 of 100Reported as group

Quality

93.38

Improvement activities

40

Cost

42.11

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.

• Middle Tennessee Eye Associates of Cookeville PLLC

  • Ophthalmology Physician
  • Cookeville, TN
  • NPI 1033305735
  Medicare reassignment NPD
• Vanderbilt University Medical Center

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1104202761
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1508893348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E VETERANS DR STE A",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014038",
            "telephone_number": "931-372-1994",
            "fax_number": "931-684-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E VETERANS DR STE A",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014038",
            "telephone_number": "931-372-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KELLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "SANDERSON",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Luis Filipe Mariusso, DMD
• Tanya Charlene Marshall, MD
• Carey Ann Martin, R.N.
• Elissa Martin
• Erin Grace Martin
• Kenneth R. Martin, D.M.D
• Melissa Martin, LPN
• Priscilla Martin, FNP
• Trey Martin
• Juan Jose Martinez Mueller, LPC MHSP

• Optometrist in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; 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.