Kelly Family Eyecare, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

KELLY FAMILY EYECARE, LLC

Practice address

458 Talcottville Rd
Suite 1
Vernon, CT 06066-4052

Phone

(860) 870-5822

NPI assigned

Jul 11, 2016

Last updated

Jul 11, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Abby Kelly, ODNPI 1669823910

Title

Owner

Phone

(860) 870-5822

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Abby Kelly, OD

  • Optometrist
  • Vernon, CT
  • NPI 1669823910
  Medicare reassignment Care Compare group Authorized official
• Danielle Gurciullo, OD

  • Optometrist
  • Windsor, CT
  • NPI 1205568144
  Medicare reassignment Care Compare group NPD
• Lauren Briana Guzik, O.D.

  • Optometrist
  • Glastonbury, CT
  • NPI 1689868291
  Medicare reassignment Care Compare group NPD
• Richard Joseph Nowak, OD MS

  • Optometrist
  • East Windsor, CT
  • NPI 1740319441
  NPD (past)

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468195200000",
    "number": "1558713859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "458 TALCOTTVILLE RD",
            "address_2": "SUITE 1",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664052",
            "telephone_number": "860-870-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "458 TALCOTTVILLE RD",
            "address_2": "SUITE 1",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664052",
            "telephone_number": "860-870-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY FAMILY EYECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-11",
        "last_updated": "2016-07-11",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "ABBY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-870-5822",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Mary Hart Johnson, PA-C
• Carolyn Botti Jones, OTR
• Harold A. Kadish, D.M.D.
• Roopkiranjot Kahlon, M.D.
• Heather Karpey, PPCNP-BC
• Abby Kelly, OD
• James Kelly, APRN
• Michael R Kelly
• Devin Keyes, LPC
• Babar R Khan, DMD

• Optometrist in Vernon, CT
• Providers in Vernon, CT by specialty
• Optometrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.