Ellen Brooke Kelly, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2280DT Issued in KY

Practice address

7727 Mall Rd Ste B
Florence, KY 41042-2666

Phone

(859) 282-1751

NPI assigned

Jun 28, 2022

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 KY

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

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ky Doctors of Optometry, PLLCGroup PAC ID 0941108732, 64 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Ky Doctors of Optometry, PLLC

  dba KY Doctors of Optometry

  • Optometrist
  • Louisville, KY
  • NPI 1700890001
  Medicare reassignment Care Compare group NPD
• Ky Doctors of Optometry, PLLC

  dba KY Doctors of Optometry

  • Eyewear Supplier
  • Florence, KY
  • NPI 1083160915

  Optometrist

  NPD (past)
• Ky Doctors of Optometry, PLLC

  dba KY Doctors of Optometry

  • Eyewear Supplier
  • Louisville, KY
  • NPI 1205919099

  Optometrist

  NPD (past)
• Ky Doctors of Optometry, PLLC

  dba KY Doctors of Optometry

  • Eyewear Supplier
  • Elizabethtown, KY
  • NPI 1427131176

  Optometrist

  NPD (past)
• Ky Doctors of Optometry, PLLC

  dba KY Doctors of Optometry

  • Eyewear Supplier
  • Louisville, KY
  • NPI 1851523575

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1609508738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2191 LUMBERJACK DR",
            "city": "HEBRON",
            "state": "KY",
            "postal_code": "410487929",
            "telephone_number": "606-260-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7727 MALL RD STE B",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410422666",
            "telephone_number": "859-282-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ELLEN",
        "middle_name": "BROOKE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "2280DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy J. Kappes, PA-C
• Arik Kashner
• Kathryn Blair Plymale LLC
• Feryal Khan Katsikas, M.A./ LPCC
• Shivam Ram Kedia, DO
• Virginia Kelly
• Kathryn Miller Kelsay, APRN
• Adam Kelsey, LMT
• Kristin Dietz Kennedy, ARNP
• Wendy Kennedy

• Optometrist in Florence, KY
• Providers in Florence, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.