Kelley Bentley, OD
Individual provider Active NPI Optometrist · Whitesburg, KY
NPI 1730856469 · NPPES record last updated Aug 30, 2021
Key facts
- NPI
- 1730856469
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2234DT (KY)
- Practice address
- 19 Solomon Rd
Whitesburg, KY 41858-7201 - Phone
- (606) 633-4481
- NPI assigned
- Aug 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211109002721 | KY | Practitioner - Optometry | 9931598141 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| D K Williams PSC | Optometrist | Current |
Accepting new patients |
Locations
92 Holly Hills Mall Rd
Hindman, KY 41822
Phone (606) 633-4481
6800 US Highway 23 S
Ste 6
Pikeville, KY 41501
Phone (606) 633-4481
19 Solomon Rd
Whitesburg, KY 41858
Phone (606) 633-4481
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 2234DT | KY | Yes |
Addresses
Primary practice location
19 Solomon Rd
Whitesburg, KY 41858-7201
Mailing address
8044 US Highway 23 S
Pikeville, KY 41501-3901
Other providers in Whitesburg, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.