Active NPI
Thomas Kelly OD Inc
- Optometrist
- Bay Village, OH
National Provider Identifier
1982093746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3675
- Legal business name
- THOMAS KELLY OD INC
- Practice address
- 433 Dover Center Rd
Bay Village, OH 44140-2355 - Phone
- (440) 871-1139
- Fax
- (440) 871-0222
- NPI assigned
- Jan 16, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Thomas M Kelly, OD
- Title
- Optometrist
- Phone
- (440) 871-1139
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3675 | OH | Primary |
Addresses
Primary practice location
433 Dover Center Rd
Bay Village, OH 44140-2355
Mailing address
433 Dover Center Rd
Bay Village, OH 44140-2355
Phone (440) 871-1139
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Thomas Kelly OD Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Eyewear Supplier
- Bay Village, OH
- NPI 1528222668
Locations
570 Dover Center Rd
Bay Village, OH 44140
Phone (440) 871-1139
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Bay Village, OH
- NPI 1285730986
-
- Optometrist
- Bay Village, OH
- NPI 1568429876
-
- Optometrist
- Rocky River, OH
- NPI 1114956786
-
- Optometrist
- Bay Village, OH
- NPI 1609428028
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421366400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1731369600000",
"number": "1982093746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "433 DOVER CENTER RD",
"city": "BAY VILLAGE",
"state": "OH",
"postal_code": "441402355",
"telephone_number": "440-871-1139",
"fax_number": "440-871-0222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "433 DOVER CENTER RD",
"city": "BAY VILLAGE",
"state": "OH",
"postal_code": "441402355",
"telephone_number": "440-871-1139",
"fax_number": "440-871-0222"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THOMAS KELLY OD INC",
"organizational_subpart": "NO",
"enumeration_date": "2015-01-16",
"last_updated": "2024-11-12",
"certification_date": "2024-11-12",
"status": "A",
"authorized_official_last_name": "KELLY",
"authorized_official_first_name": "THOMAS",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "OPTOMETRIST",
"authorized_official_telephone_number": "440-871-1139",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "OH",
"license": "3675",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bay Village, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.