Kelly H Nilsson, OD, PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

KELLY H NILSSON, OD, PA

Doing business as

Nilsson Eye Care

Practice address

3580 Massee LN Ste G
Columbus, GA 31909-2586

Phone

(762) 583-6110

NPI assigned

Oct 11, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Kelly Honsinger Nilsson, OD

Title

President

Phone

(601) 347-1725

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• Nilsson Eye Care Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David A Rossello, O.D.

  • Optometrist
  • Columbus, GA
  • NPI 1558329771
  NPD (past)

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629936000000",
    "number": "1578815742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 STEELE CREEK DR",
            "city": "MIDLAND",
            "state": "GA",
            "postal_code": "318204647",
            "telephone_number": "601-347-1725",
            "fax_number": "706-682-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 MASSEE LN STE G",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092586",
            "telephone_number": "762-583-6110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1851 Manchester Expy Ste B",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319046761",
            "country_code": "US",
            "telephone_number": "706-653-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KELLY H NILSSON, OD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-11",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A",
        "authorized_official_last_name": "NILSSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "HONSINGER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-347-1725",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "4662",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002997",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "842",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "A10819",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA VCP",
            "identifier": "A10819",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nilsson Eye Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nilsson Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew Keller, D.M.D.
• Jason Kelley
• Olivia Henderson Kelley, NP
• Sandra K Kelley, CRNP
• Kenarin Kellogg
• Cammillia Shannae Kelly
• Janetta M Kelly, M.D.
• Jessica Kelly, CPNP
• John Kelly, MPH
• Latonya Kelly

• Optometrist in Columbus, GA
• Providers in Columbus, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.