Kelley Lawrence, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1757 Issued in AZ

Practice address

21300 N John Wayne Pkwy Ste 105
Maricopa, AZ 85139-8964

Phone

(520) 201-3937

Fax

(520) 201-3939

NPI assigned

Jul 22, 2010

Last updated

Jun 14, 2020By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

John H McDougall OD Arizona PCGroup PAC ID 3274880117, 44 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Desert Eyecare Center

  • Optometrist
  • Maricopa, AZ
  • NPI 1477800126
  Medicare reassignment NPD Authorized official
• John H McDougall OD Arizona PC

  dba 20/20 Image Eye Centers

  • Optometrist
  • Fountain Hills, AZ
  • NPI 1851882179
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592092800000",
    "number": "1568775229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21300 N JOHN WAYNE PKWY STE 105",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851398964",
            "telephone_number": "520-201-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21300 N JOHN WAYNE PKWY STE 105",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851398964",
            "telephone_number": "520-201-3937",
            "fax_number": "520-201-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "KELLEY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-22",
        "last_updated": "2020-06-14",
        "certification_date": "2020-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• La Grace Home Care Services LLC
• La Laser Center PC, a Professional Medical Corporation (Maricopa Dermatology & Skin Cancer)
• Carolyn Renee Lacy
• David Lar, MD
• Lavie Home LLC
• Katlyn Brooke Lawson
• William Glenn Lay, D.C.
• Chris G. Le, RRT
• Legacy Healthcare Solutions, Inc.
• Liberated Rehabilitation, PLLC

• Optometrist in Maricopa, AZ
• Providers in Maricopa, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2020; 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.