Kelly Minnich, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3242 Issued in MN

Practice address

9220 Boehm Dr
Lenexa, KS 66219-2198

Phone

(612) 250-7355

NPI assigned

Oct 14, 2009

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 MN

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

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.

• Crystal Vision Clinic PA

  • Optometrist
  • Crystal, MN
  • NPI 1720480007
  NPD
• James J Hess & Scott Endres

  • Optometrist
  • Crystal, MN
  • NPI 1215934880
  NPD (past)
• Optometric Eye Care Centers, PA

  • Optometrist
  • Maplewood, MN
  • NPI 1730203597
  NPD (past)

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

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311292800000",
    "number": "1639404296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9220 BOEHM DR",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662192198",
            "telephone_number": "612-250-7355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9220 BOEHM DR",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662192198",
            "telephone_number": "612-250-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNICH",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-14",
        "last_updated": "2011-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Eugene Miller Jr., DDS
• David A. Milligan, R.PH.
• Trenidy Jayne Milliken
• Mind Body Shen
• Minimally Invasive Surgery Hospital
• Mint Dental Oak Park, LLC.
• Missouri Hospice Holdings, LLC
• Mitchell Chiropractic and Wellness Center LLC
• Alison Erin Mitchell, DPT
• Sara Michelle Mitchell, D.C.

• Optometrist in Lenexa, KS
• Providers in Lenexa, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.