Thomas R Kelley, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG001407 Issued in PA

Practice address

5800 Peach St
Erie, PA 16565-1601

Phone

(814) 864-2020

Fax

(814) 868-8534

NPI assigned

Feb 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270684800000",
    "number": "1528100419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SAINT MARY DR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092975",
            "telephone_number": "814-866-5599",
            "fax_number": "814-866-5599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165651601",
            "telephone_number": "814-864-2020",
            "fax_number": "814-868-8534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "THOMAS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2010-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tasha Keith
• Evelyn Keller, RN, BSN
• Bethany Kelley, PA-C
• Janet E Kelley, CRNP
• Karen Kelley, CRNP
• Kellie L. Valentine LPC LLC
• Colton Thomas Kellogg, PT, DPT, CSCS
• Kelly Cathleen Kelly-Zazado, LCSW/ACSW
• Ann E. Kelly, CRNA
• Christian Elizabeth Kelly, LPC

• Optometrist in Erie, PA
• Providers in Erie, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.