Dr Donald B Kelly LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618000499 Issued in VA

Legal business name

DR DONALD B KELLY LLC

Practice address

880 N Military Hwy
1087
Norfolk, VA 23502-3716

Phone

(757) 466-1574

Fax

(757) 466-2993

NPI assigned

Feb 25, 2009

Last updated

Feb 25, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Donald B Kelly, O.D.

Title

Owner

Phone

(757) 466-1574

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235520000000",
    "number": "1821238296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 N MILITARY HWY",
            "address_2": "1087",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023716",
            "telephone_number": "757-466-1574",
            "fax_number": "757-466-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 N MILITARY HWY",
            "address_2": "1087",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023716",
            "telephone_number": "757-466-1574",
            "fax_number": "757-466-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR DONALD B KELLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-25",
        "last_updated": "2009-02-25",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-466-1574",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009230424",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2009; 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.