Kelli Ann Smith, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2016040124 Issued in MO

Practice address

220 W 75TH St
Kansas City, MO 64114

Phone

(816) 523-8421

Fax

(816) 523-0909

NPI assigned

Jun 27, 2011

Last updated

Dec 13, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Kelli Ann Bunger Former name

Medicare fee-for-service enrollment

Enrolled in KS, MO2 enrollments

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 2

Specialty

Optometry

Education

Indiana University - School of Optometry, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Littlefield Eye Associates LLCGroup PAC ID 0648173427, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Littlefield Eye Associates, LLC

  • Optometrist
  • Kansas City, MO
  • NPI 1386715977
  Medicare reassignment Care Compare group NPD
• Westglen Eyecare PA

  • Optometrist
  • Shawnee, KS
  • NPI 1023178407
  Medicare reassignment NPD
• Wonchon Lin, M.D., PLLC

  dba Westwood Eye

  • Ophthalmology Physician
  • Las Vegas, NV
  • NPI 1902443542
  NPD

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1811283914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W 75TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64114",
            "telephone_number": "816-523-8421",
            "fax_number": "816-523-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W 75TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64114",
            "telephone_number": "816-523-8421",
            "fax_number": "816-523-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELLI",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-27",
        "last_updated": "2021-12-13",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2016040124",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "2046",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "BUNGER",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julie Smith, LMSW
• Kaitlyn Rae Smith
• Karen G Smith, RN,ARNP
• Kasey Smith
• Katharine Rose Smith
• Kelly Smith, MHS, CCC-SLP
• Kendra Lauren Smith, COTA
• Kevin C Smith, PH.D.
• Khanh Luu Smith, PHARMD
• Kim K. Smith, M.D.

• Optometrist in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.