Individual provider Active NPI

Kelly Schoorens, O.D.

  • Optometrist
  • Manchester, NH
National Provider Identifier
1619329315
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003199 Issued in PA
Practice address
718 Smyth Rd
Manchester, NH 03104-7007
Phone
(603) 624-4366
NPI assigned
Jul 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003199 PA Primary

Addresses

Primary practice location

718 Smyth Rd
Manchester, NH 03104-7007

Mailing address

718 Smyth Rd
Manchester, NH 03104-7007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171128000386 RI Practitioner - Optometry 4981961067
I20190410001014 NH Practitioner - Optometry 4981961067 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG003199PAMDOptometrist
0935NHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph P Larochelle Optometrist CurrentSince Mar 15, 2019 Accepting new patients
Concord Family Vision, PLLC CurrentSince Mar 15, 2019 Accepting new patients

Locations

8 N State St
Concord, NH 03301
Phone (603) 225-2512

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1619329315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 SMYTH RD",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031047007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 SMYTH RD",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031047007",
            "telephone_number": "603-624-4366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOORENS",
        "first_name": "KELLY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.