Kelly Anderson OD PA

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

OPC 3770 Issued in FL

Legal business name

KELLY ANDERSON OD PA

Practice address

15495 Tamiami TRL N
Suite 124
Naples, FL 34110-6206

Phone

(239) 593-4801

Fax

(239) 593-3019

NPI assigned

Jul 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kelly Anderson, ODNPI 1982702114

Title

President

Phone

(239) 297-2883

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly D Anderson, OD

  • Corneal and Contact Management Optometrist
  • Naples, FL
  • NPI 1982702114
  NPD (past) Authorized official

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185408000000",
    "number": "1801094933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13300 S CLEVELAND AVE STE 56",
            "address_2": "SUITE 153",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073871",
            "telephone_number": "239-297-2883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15495 TAMIAMI TRL N",
            "address_2": "SUITE 124",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341106206",
            "telephone_number": "239-593-4801",
            "fax_number": "239-593-3019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY ANDERSON OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2007-07-26",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-297-2883",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "FL",
            "license": "OPC 3770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassidy Rose Keller
• Diane M Keller
• Jennifer Lee Keller, APRN
• James Sheridan Kelley, MD
• Laura Kathryn Kelley, PHARMD
• Cynthia Kelly, PA-C
• Jonathan Kelly, PHARMD
• Karen S Kelly, CRNA
• Stephanie Sue Kemp, LMSW
• Matthew Kempfer, PT, DPT

• Corneal and Contact Management Optometrist in Naples, FL
• Providers in Naples, FL by specialty
• Corneal and Contact Management Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; 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.