Individual provider Active NPI

Kelli Lee Parks, OD

  • Optometrist
  • Pensacola, FL
National Provider Identifier
1992791990
Registry record updated Apr 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3149 Issued in FL
Practice address
8333 N Davis Hwy
Pensacola, FL 32514-6050
Phone
(850) 474-8220
Fax
(850) 969-2989
NPI assigned
Sep 25, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3149 FL Primary

Addresses

Primary practice location

8333 N Davis Hwy
Pensacola, FL 32514-6050

Mailing address

8333 N Davis Hwy
Pensacola, FL 32514-6050
Phone (850) 474-8220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20031204000983 FL Practitioner - Optometry 8729983440 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kelli L. Parks, OD, LLC Optometrist CurrentSince Jan 18, 2013 Accepting new patients
Aeg Florida Professional PLLC Optometrist CurrentSince Apr 4, 2023 Accepting new patients
West Florida Medical Center Clinic PA Past Accepting new patients
Coppedge and Wooster PA Optometrist PastSince Jun 1, 2016 Accepting new patients
Ocala Eye PA Optometrist Past Accepting new patients
Eye Care Physicians Inc Past Accepting new patients
Emerald Coast Eye Institute, LLC Optometrist PastSince Jan 1, 1990 Accepting new patients
Emerald Coast Eye Institute LLC PastSince Jan 1, 1990 Accepting new patients
Optometric Associates of Florida, P.a. Optometrist Past Accepting new patients

Locations

740 Beal Pkwy N
Fort Walton Beach, FL 32547
Phone (850) 862-0101

4788 Hodges Blvd
Ste 205
Jacksonville, FL 32224
Phone (904) 992-9991

560 Rinehart Rd
Ste 100
Lake Mary, FL 32746
Phone (407) 333-7333

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://app.meldrx.com/api/fhir/ec21ei41

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1127606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334793600000",
    "number": "1992791990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8333 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325146050",
            "telephone_number": "850-474-8220",
            "fax_number": "850-969-2989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8333 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325146050",
            "telephone_number": "850-474-8220",
            "fax_number": "850-969-2989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "KELLI",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-25",
        "last_updated": "2012-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "3149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.