Kelly Michael Duncan, O D

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD1592 Issued in TN

Practice address

1000A Vann Dr
Jackson, TN 38305-6001

Phone

(731) 668-3018

Fax

(731) 668-9158

NPI assigned

May 27, 2006

Last updated

May 21, 2024By the provider in NPPES

Sex

Male

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 5

Medicare fee-for-service enrollment

Enrolled in TN

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

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Tennessee LLCGroup PAC ID 1759646995, 45 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.

• Myeyedr Optometry of Tennessee, LLC

  dba MyEyeDr.

  • Optometrist
  • Chattanooga, TN
  • NPI 1619481587
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Tennessee, LLC

  dba MyEyeDr

  • Optometrist
  • Memphis, TN
  • NPI 1497230130
  NPD
• Myeyedr Optometry of Tennessee, LLC

  • Optometrist
  • Mount Juliet, TN
  • NPI 1588516918
  NPD

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1912954983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000A VANN DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383056001",
            "telephone_number": "731-668-3018",
            "fax_number": "731-668-9158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "KELLY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "OD1592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3943183",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMEPOS",
            "identifier": "5466560004",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TLC MEMPHIS MANAGED CARE",
            "identifier": "6414",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "4105782",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "4239243",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caitlyn Manning Dulaney
• Hunter Allen Dulaney, MD
• Kylie Blair Dunavan
• Emily Makayla Dunaway, FNP-C
• Shane Paul Dunaway, APN
• William Shannon Dunlap, DPH
• Chelsea Dunn
• Grace Dunn, LCSW
• Robert H Dunnebacke, M.D.
• Duo Services Inc (Comfort Keepers)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.