NPIMap

Individual provider Active NPI

Christopher Lee Kelly, O.D.

  • Optometrist
  • Thief River Falls, MN
National Provider Identifier
1801827266
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3260 Issued in MN
Practice address
1720 Highway 59 S
Thief River Falls, MN 56701-4331
Phone
(218) 681-4747
NPI assigned
Jul 5, 2006
Last updated
Mar 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3167ATI OR
Optometrist 152W00000X 3260 MN Primary

Addresses

Primary practice location

1720 Highway 59 S
Thief River Falls, MN 56701-4331

Mailing address

PO Box 2010
Fargo, ND 58122-2484
Phone (701) 234-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ckelly1841706@direct.sanfordhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111221000751 MN Practitioner - Optometry 3173676996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Health Network NorthGroup PAC ID 8022206663, 114 clinicians

Practice addresses (Care Compare)

1720 Hwy 59 S
Thief River Falls, MN 56701-4331
Phone (218) 681-4747

Merit-based Incentive Payment System (MIPS)

Final score
90.22 of 100Reported as group
Quality
90.28
Promoting interoperability
100
Improvement activities
40
Cost
72.7

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3260MNMDRegistered Dietitian
3167ATIORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health Network North CurrentSince Feb 1, 2018 Accepting new patients
Sanford Health Network North CurrentSince Feb 1, 2018 Accepting new patients
Sanford Health Network North Optometrist Current Accepting new patients
Sanford Health Network North Past Accepting new patients
Makayla Adams OD PC Optometrist PastSince Jun 3, 2025 Accepting new patients
Lynn E Goodwin OD PC Optometrist Past Accepting new patients

Locations

1720 US Highway 59 SE
Thief Rvr Fls, MN 56701
Phone (218) 681-4747

3001 Sanford Pkwy
Thief Rvr Fls, MN 56701
Phone (218) 681-4240

Interoperability endpoints

  • Direct secure messaging: ckelly1841706@direct.sanfordhealth.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1801827266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2010",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581222484",
            "telephone_number": "701-234-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 HIGHWAY 59 S",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567014331",
            "telephone_number": "218-681-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CHRISTOPHER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3167ATI",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckelly1841706@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "1720 Highway 59 S",
            "city": "Thief River Falls",
            "state": "MN",
            "country_code": "US",
            "postal_code": "567014331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Thief River Falls, MN

Sources for this page

Verify at the official NPI Registry.