Kelly Jo Makley, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

6145 Issued in OH

Practice address

1475 Upper Valley Pike
Springfield, OH 45504-4047

Phone

(937) 525-9266

Fax

(937) 525-9633

NPI assigned

Jul 17, 2012

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

Other names 1

• Kelly Jo Zink Former name

Medicare fee-for-service enrollment

Enrolled in OH

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

Ohio State University - College of Optometry, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Ohio Professional PCGroup PAC ID 7618207036, 80 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.

• Aeg Ohio Professional PC

  • Optometrist
  • Solon, OH
  • NPI 1154980811
  Medicare reassignment Care Compare group NPD
• Aeg Ohio Professional PC

  • Optometrist
  • Cincinnati, OH
  • NPI 1932708047
  NPD
• Breslow Eye Care LLC

  • Optometrist
  • Springfield, OH
  • NPI 1851628416
  NPD (past)

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1639424633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 STRINGTOWN RD",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "431232928",
            "telephone_number": "937-525-9266",
            "fax_number": "937-525-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 UPPER VALLEY PIKE",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455044047",
            "telephone_number": "937-525-9266",
            "fax_number": "937-525-9633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKLEY",
        "first_name": "KELLY",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "ZINK",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mitchell J Maginnis, OD
• Mark Thomas Main, PT
• Jenna Mains
• Patricia A Mairet, MFT
• Mtanious Makhoul, MD
• Nicholas Eugene Maksim, D.O., R.PH.
• Christopher Malone, D.O.
• Monica L Malone, APRN, MSN, PMHNP
• Terrisue Jean Malone, LSW
• Rebecca E Malott, ACNP

• Optometrist in Springfield, OH
• Providers in Springfield, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; 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.