Individual provider Active NPI

Kelly Moser, O.D.

  • Optometrist
  • Athens, OH
National Provider Identifier
1962632737
Registry record updated Jul 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5884 Issued in OH
Practice address
199 Columbus Rd
Athens, OH 45701-1315
Phone
(740) 593-3191
Fax
(740) 594-2525
NPI assigned
Jul 15, 2009
Last updated
Jul 15, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5884 OH Primary

Addresses

Primary practice location

199 Columbus Rd
Athens, OH 45701-1315

Mailing address

PO Box 668
Athens, OH 45701-0668
Phone (740) 593-3191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20091201000565 OH Practitioner - Optometry 1951440163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Athens Eye Professionals LLCGroup PAC ID 2163473257, 3 clinicians

Practice addresses (Care Compare)

199 Columbus Rd
Athens, OH 45701-1315
Phone (740) 593-3191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5884OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Arnold P. Lagraff & Kathy Biddinger LLC Optometrist CurrentSince Oct 2, 2009 Accepting new patients
Athens Eye Professionals LLC Optometrist CurrentSince Oct 2, 2009 Accepting new patients

Locations

199 Columbus Rd
Athens, OH 45701
Phone (240) 593-3191

72 W Washington St
Nelsonville, OH 45764
Phone (740) 753-1967

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247616000000",
    "number": "1962632737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 668",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457010668",
            "telephone_number": "740-593-3191",
            "fax_number": "740-594-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 COLUMBUS RD",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457011315",
            "telephone_number": "740-593-3191",
            "fax_number": "740-594-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSER",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-15",
        "last_updated": "2009-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, OH

Sources for this page

Verify at the official NPI Registry.