Kelly Ann Ganser, LDO

Primary specialty

OpticianTaxonomy code 156FX1800X

License

008861 Issued in NY

Practice address

8064 Brewerton Rd
Cicero, NY 13039-9621

Phone

(315) 698-0473

Fax

(315) 698-0498

NPI assigned

Oct 3, 2024

Last updated

Oct 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kelly Ann Houck Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1727913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1689493025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8064 BREWERTON RD",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "130399621",
            "telephone_number": "315-698-0473",
            "fax_number": "315-698-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8064 BREWERTON RD",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "130399621",
            "telephone_number": "315-698-0473",
            "fax_number": "315-698-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANSER",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "LDO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-03",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "008861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "HOUCK",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Madeline T Frank, PA-C
• Deette Ann Frary, M.S., ATR-BC, LCAT
• Dominique D Frasier, M.S.ED
• Catherine Marie Fuller
• Shannon Marie Galarneau, LMSW
• Charbel Ghosn, DMD
• Erika J Glasso, BC-HIS
• Emily Glisson, NP
• Wendy Gorman
• Nicole Goult, FNP

• Optician in Cicero, NY
• Providers in Cicero, NY by specialty
• Optician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.