Kelly Heren, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT003284 Issued in GA

Practice address

279 N Broad St Ste C
Winder, GA 30680-2589

Phone

(770) 867-2505

NPI assigned

Jun 14, 2016

Last updated

Aug 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Nova Southeastern College of Osteo Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Winder Eye Care CenterGroup PAC ID 1153312871, 4 clinicians

Premier Vision PartnersGroup PAC ID 1850789553, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Premier Vision Partners

  • Optometrist
  • Braselton, GA
  • NPI 1376213165
  Medicare reassignment Care Compare group NPD
• Winder Eye Care Center

  • Optometrist
  • Winder, GA
  • NPI 1154349041
  Medicare reassignment Care Compare group NPD
• Eye 1St Holdings LLC

  dba Eye 1st Vision Center

  • Optometrist
  • Sandy Springs, GA
  • NPI 1699830091
  Medicare reassignment NPD
• Ga Doctors of Optometry LLC

  • Optometrist
  • Lithonia, GA
  • NPI 1174105936
  Medicare reassignment NPD
• Map Eyes LLC

  dba Eyes On Providence

  • Optometrist
  • Marietta, GA
  • NPI 1750654141
  Medicare reassignment NPD
• Ga Doctors of Optometry LLC

  • Eyewear Supplier
  • Columbus, GA
  • NPI 1013599745

  Optometrist

  NPD
• Eecarman OD PC

  dba Classic Vision Care

  • Optometrist
  • Kennesaw, GA
  • NPI 1205155116
  NPD (past)
• Georgia Eye LLC

  dba Georgia Eye

  • Ophthalmology Physician
  • Athens, GA
  • NPI 1588213284

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1740630466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 ROSWELL RD STE 8",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628827",
            "telephone_number": "678-560-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 N BROAD ST STE C",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306802589",
            "telephone_number": "770-867-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEREN",
        "first_name": "KELLY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-14",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 5211",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Winder, GA
• Providers in Winder, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.