Kelly John Corbridge, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

829 Issued in AZ

Practice address

2187 Airway Ave.
Kingman, AZ 86409-3669

Phone

(928) 757-5005

NPI assigned

Aug 13, 2007

Last updated

May 12, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Pacific University - College of Optometry, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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.

• Desert Family Eye Center, P.C.

  • Optometrist
  • Kingman, AZ
  • NPI 1689630832
  Medicare reassignment NPD Authorized official
• Total Eyecare Centers, PLLC

  • Optometrist
  • Tempe, AZ
  • NPI 1851719538
  NPD (past)

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1902098007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2187 AIRWAY AVE.",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093669",
            "telephone_number": "928-757-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2187 AIRWAY AVE.",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093669",
            "telephone_number": "928-757-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBRIDGE",
        "first_name": "KELLY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-13",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connections Therapy Group LLC
• Regina T Conrad
• Cook Family Practice Inc
• Karrie Ann Cook, NP
• Ladana Kay Cook, LPN
• Stevie-Marie Cordero, BT/RBT
• Cornerstone Caregiving West LLC
• Israel Coronado, C.R.N.A.
• Rebecca Coulson
• County of Mohave (Mohave County Department of Public Health)

• Optometrist in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.