DR. DOUGLAS EDWARD KELLEY (NPI# 1033376090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033376090 |
| Entity Type | Individual |
| Full Name | DR. DOUGLAS EDWARD KELLEY |
| Credential | OD |
| Practice Address |
540 E Grand Ave Beloit WI 53511-6314 |
| Mailing Address |
531 E Grand Ave Beloit WI 53511-6313 |
| Practice Telephone | 6083658575 |
| Practice Fax Number | 6083622625 |
| Mailing Telephone | 6083658575 |
| Mailing Fax Number | 6083622655 |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2016-07-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 3136-035 | WI | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285654509 | Douglas M Kelley | Anesthesiology | 3508 22nd Pl, Lubbock, TX 79410-1316 | 2006-07-20 |
| 1962498345 | Douglas James Kelley | Optometrist | 308 S New York Rd Unit D, Galloway, NJ 08205-9650 | 2005-09-21 |
| 1427303189 | Douglas Farrell Kelley | Physical Therapist | 2519 S Lakeline Blvd, Suite 100, Cedar Park, TX 78613-2964 | 2012-07-18 |
| 1306108428 | Douglas John Kelley | Emergency Medicine | 5450 Fort St, Trenton, MI 48183-4601 | 2012-06-14 |
| Street Address |
540 E GRAND AVE |
| City | BELOIT |
| State | WI |
| Zip Code | 53511-6314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740896885 | Taylor Leibfried | Social Worker | 540 E Grand Ave, Beloit, WI 53511-6314 | 2020-09-22 |
| 1396376851 | Nicolette Ann Miller | Social Worker | 540 E Grand Ave, Beloit, WI 53511-6314 | 2020-02-03 |
| 1407401771 | Amberly Jean Mixon | Social Worker | 540 E Grand Ave, Beloit, WI 53511-6314 | 2019-08-05 |
| 1407345903 | Brielle Evelyn Powers | Social Worker | 540 E Grand Ave, Beloit, WI 53511-6314 | 2018-05-09 |
| 1740704287 | Melony Dawn Walsh | Counselor | 540 E Grand Ave, Beloit, WI 53511-6314 | 2017-07-26 |
| 1821510595 | Jenniffer Beu | Counselor | 540 E Grand Ave, Beloit, WI 53511-6314 | 2017-07-13 |
| 1568853091 | David Fischer | Social Worker | 540 E Grand Ave, Beloit, WI 53511-6314 | 2015-02-05 |
| 1538560255 | Stateline Mental Health Services | Clinic/Center | 540 E Grand Ave, Beloit, WI 53511-6314 | 2014-09-12 |
| 1982986261 | Stephanie Sisson | Counselor | 540 E Grand Ave, Beloit, WI 53511-6314 | 2011-09-13 |
| 1780976647 | Beloit Family Eye Care S.c. | Optometrist | 540 E Grand Ave, Beloit, WI 53511-6314 | 2011-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730738485 | Linda Lee Cook | Technician | 914 Cranston Rd., Beloit, WI 53511 | 2019-09-05 |
| 1033773734 | Holistic Counseling Services, LLC | Counselor | 1517 Huebbe Parkway, Ste A, Beloit, WI 53511 | 2019-04-28 |
| 1578073870 | Bonita May Cooke | Counselor | 838 Grant St., Beloit, WI 53511 | 2017-10-02 |
| 1679091219 | Stacy Lynn Gallagher | Licensed Practical Nurse | 1060 Bittel St, Beloit, WI 53511 | 2017-09-04 |
| 1629448824 | Brenda Jean Allen | Registered Nurse | 2907 E. Leona Drive, Beloit, WI 53511 | 2015-09-30 |
| 1033595038 | Amber Noel Slaybaugh | Physical Therapist | 838 E. Azalea Ter., Beloit, WI 53511 | 2015-08-03 |
| 1407260326 | Quirt Family Dentistry, Sc | Dentist | 2777 Milwaukee Rd, Beloit, WI 53511 | 2014-06-18 |
| 1821436973 | Raymond K Spade | Counselor | 2240 Prairie Ave., Beloit, WI 53511 | 2013-06-11 |
| 1629321658 | Sarah Ann Nelson | Physical Therapist | 1905 W. Hart Road, Beloit, WI 53511 | 2012-10-15 |
| 1235494212 | Mary Ann Hudson | Nurse Practitioner | 700 College Street, Beloit College, Beloit, WI 53511 | 2012-07-06 |
| Find all providers in zip 53511 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891145751 | Kurt Robert Olson | Optometrist | 124 N Mill St, Beloit, KS 67420-2344 | 2016-06-21 |
| 1740333806 | Vision & Eye Health Associates, LLC | Optometrist | 1035 Pleasant St Ste C, Beloit, WI 53511-4453 | 2007-01-19 |
| 1053408575 | Bren Alden Myers | Optometrist | 124 N Mill, Beloit, KS 67420-3239 | 2006-10-06 |
| 1659322568 | Anthony Jon Drew | Optometrist | 2761 Prairie Ave, Beloit, WI 53511-2246 | 2006-05-15 |
| 1669438487 | Cynthia J Rehbein | Optometrist | Beloit Health System Inc, 1905 E Huebbe Parkway, Beloit, WI 53511-1842 | 2006-04-21 |
| 1609865120 | Chad Justin Thompson | Optometrist | 214 N Mill St, Beloit, KS 67420-2346 | 2005-10-18 |
| 1780976647 | Beloit Family Eye Care S.c. | Optometrist | 540 E Grand Ave, Beloit, WI 53511-6314 | 2011-05-11 |
| 1962509927 | Chad J Thompson Od Chartered | Optometrist | 206 S Mill St, Beloit, KS 67420-3239 | 2006-09-20 |
| 1174531834 | Alan J Rehbein | Optometrist | 1905 E. Huebbe Parkway, Beloit Health System Inc., Beloit, WI 53511-1842 | 2006-08-04 |
| 1578535654 | Drs. Cooper & Banninger, LLC. | Optometrist | 112 W Main St, Beloit, KS 67420-2745 | 2006-02-03 |
| Find all providers in BELOIT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.