Kelly Lynne Cunningham, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

18003161B Issued in IN

Practice address

219 E Washington St
Martinsville, IN 46151-1554

Phone

(765) 342-6654

Fax

(765) 342-0418

NPI assigned

Jul 15, 2005

Last updated

Oct 1, 2008By 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 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

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

Indiana University - School of Optometry, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Martinsville Vision Clinic PCGroup PAC ID 4486653508, 2 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.

• Martinsville Vision Clinic PC

  • Optometrist
  • Martinsville, IN
  • NPI 1679673495
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222819200000",
    "number": "1881693547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 E WASHINGTON ST",
            "city": "MARTINSVILLE",
            "state": "IN",
            "postal_code": "461511554",
            "telephone_number": "765-342-6654",
            "fax_number": "765-342-0418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 E WASHINGTON ST",
            "city": "MARTINSVILLE",
            "state": "IN",
            "postal_code": "461511554",
            "telephone_number": "765-342-6654",
            "fax_number": "765-342-0418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "KELLY",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-15",
        "last_updated": "2008-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003161B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200341850A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1679673495",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dylan Courtney
• Scott Crays
• Crosstown Eyecare LLC
• Crosstown Optical (Crosstown Eyecare)
• Aaron Booth Cunningham, OD
• Nestor Ortega Daba
• Dalton Medical Transport
• David M Sparks DDS
• Jennifer Fawn Davis, MSOTR
• Kevin Deloria, D.D.S.

• Optometrist in Martinsville, IN
• Providers in Martinsville, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; 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.