Marie C Kelly

Primary specialty

OptometristTaxonomy code 152W00000X

License

TNOD1121 Issued in TN

Legal business name

MARIE C KELLY

Practice address

110 Glancy St
Ste 208
Goodlettsville, TN 37072

Phone

(615) 868-2877

Fax

(615) 870-5771

NPI assigned

Mar 11, 2008

Last updated

Dec 9, 2008By 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

Marie C Kelly, O.D.NPI 1770692238

Title

Optometrist

Phone

(615) 868-2877

Specialties & licenses 1

Addresses

Interoperability endpoints

• Direct secure messaging: daniel@kellyvision.eyefinity-direct.com
• Direct secure messaging: marie@kellyvision.eyefinity-direct.com

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marie C Kelly, O.D..

  • Optometrist
  • Goodlettsville, TN
  • NPI 1770692238
  Authorized official Same address or phone
• Joseph Daniel Kelly Jr., O.D.

  • Optometrist
  • Goodlettsville, TN
  • NPI 1881042943
  NPD

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228780800000",
    "number": "1891965380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 GLANCY ST",
            "address_2": "STE 208",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "37072",
            "telephone_number": "615-868-2877",
            "fax_number": "615-870-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 GLANCY ST",
            "address_2": "STE 208",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "37072",
            "telephone_number": "615-868-2877",
            "fax_number": "615-870-5771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIE C KELLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2008-12-09",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "615-868-2877",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "TNOD1121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Goodlettsville, TN
• Providers in Goodlettsville, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; 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.