Corey Breen Kelly, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2223 Issued in IA

Practice address

555 John F Kennedy Rd
Suite 665
Dubuque, IA 52002-5202

Phone

(563) 582-5198

Fax

(563) 582-5540

NPI assigned

Nov 2, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

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, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Woodland Eye Clinic PCGroup PAC ID 4486883998, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: corey.kelly@direct.revolutionehr.com

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.

• Woodland Eye Clinic, PC

  • Optometrist
  • Dyersville, IA
  • NPI 1053741983
  Medicare reassignment Care Compare group NPD
• Woodland Eye Clinic, PC

  • Optometrist
  • West Union, IA
  • NPI 1023878485
  NPD

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720166945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 JOHN F KENNEDY RD",
            "address_2": "SUITE 665",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520025202",
            "telephone_number": "563-582-5198",
            "fax_number": "563-582-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 JOHN F KENNEDY RD",
            "address_2": "SUITE 665",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520025202",
            "telephone_number": "563-582-5198",
            "fax_number": "563-582-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "COREY",
        "middle_name": "BREEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "2223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED PROVIDER NUMBER",
            "identifier": "IA2223",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teri Lynn Keleher
• Angel Robin Keller, MSN, FNP-BC
• Victoria Rose Kellesvig
• Amber L Kelley, PHARMD
• Angela Diane Kelley, D.O.
• Robert S Kelsey, D.P.M.
• Amber N Kemp, ARNP
• David Michael Kemp, M.D.
• Katherine Anne Kemp, SLP
• Erin M Kennedy, MD

• Optometrist in Dubuque, IA
• Providers in Dubuque, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.