DR. KELLY G ROSS (NPI# 1073549200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073549200 |
| Entity Type | Individual |
| Full Name | DR. KELLY G ROSS |
| Credential | O.D. |
| Practice Address |
1014 W Main St Walnut Ridge AR 72476-1004 |
| Mailing Address |
Po Box 349 Walnut Ridge AR 72476-0349 |
| Practice Telephone | 8708862632 |
| Practice Fax Number | 8708861514 |
| Mailing Telephone | 8708862632 |
| Mailing Fax Number | 8708861514 |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2008-12-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2485 | AR | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 137089722 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316509805 | Kelly J Ross | Behavior Technician | 3819 Remington Cir, Anchorage, AK 99507-2888 | 2019-07-03 |
| 1821322314 | Kelly B. Ross | Social Worker | 5900 Goodman Rd., Suite B, Olive Branch, MS 38654 | 2009-09-30 |
| 1205989886 | Kelly L. Ross | Counselor | 2800 E Madison St Ste 203, Seattle, WA 98112-4865 | 2007-01-19 |
| 1427107929 | Kelly Marie Ross | Speech-Language Pathologist | 15802 N. Parkview Place, Surprise, AZ 85374 | 2007-01-10 |
| 1770675399 | Kelly D Ross | Family Medicine | 140 W 4th St Ste 1, Saint Ansgar, IA 50472-1352 | 2006-09-29 |
| 1821602475 | Kelly Ross | Community Health Worker | 1841 Madora Ave, Douglas, WY 82633-3057 | 2020-09-01 |
| 1285903237 | Kelly Christine Ross | Social Worker | 11201 Benton St, Loma Linda, CA 92357-1000 | 2011-12-21 |
| 1205139425 | Kelly Ray Ross | Behavioral Analyst | 1125 W Spruce St, Olathe, KS 66061-3123 | 2010-12-09 |
| 1790004539 | Kelly Griffith Ross | Internal Medicine | 200 Lothrop St, Suite N713, Pittsburgh, PA 15213-2536 | 2010-05-19 |
| 1205005253 | Kelly Marie Ross | Physical Therapist | 970 Greentree Rd, Pittsburgh, PA 15220-3304 | 2008-02-25 |
| Street Address |
1014 W MAIN ST |
| City | WALNUT RIDGE |
| State | AR |
| Zip Code | 72476-1004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982760955 | Kelly G Ross Od Pa | Optometrist | 1014 W Main St, Walnut Ridge, AR 72476-1004 | 2006-12-28 |
| 1215025119 | Southern Eye Associates, Ltd | Optometrist | 1014 W Main St, Walnut Ridge, AR 72476-1004 | 2006-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871113126 | Lauren Felts | Pharmacist | 1405 W Main Suite B, Walnut Ridge, AR 72476 | 2020-04-16 |
| 1033609995 | Misty Dawn Colvey | Specialist/Technologist | 60 W Fulbright Avenue, Walnut Ridge, AR 72476 | 2018-05-16 |
| 1427570803 | Heartline Home Care LLC | Home Health | 329 West Poplar, Walnut Ridge, AR 72476 | 2017-07-07 |
| 1093246035 | Allyson Claire Smith | Case Manager/Care Coordinator | 1425 W Main, Walnut Ridge, AR 72476 | 2017-03-22 |
| 1780134098 | H4l Ranch, Inc. | Community Based Residential Treatment Facility, Mental Illness | 853 Us 63, Walnut Ridge, AR 72476 | 2016-10-11 |
| 1386023943 | Meghon Lanae Mink | Physical Therapist | 200 South Memorial Drive, Walnut Ridge, AR 72476 | 2015-05-28 |
| 1013308436 | Meaghan Danielle Kingston | Nurse Practitioner | 1045 W Main St Ste C, Walnut Ridge, AR 72476 | 2015-02-06 |
| 1962789826 | Amber Fawn Adams | Family Medicine | 402 Sw Larkspur Dr, Walnut Ridge, AR 72476 | 2011-11-07 |
| 1528348760 | Pamela Wilcoxson | Case Manager/Care Coordinator | 1425 West Main, Walnut Ridge, AR 72476 | 2011-08-19 |
| 1184928764 | Lauara Beth Rhein | Case Manager/Care Coordinator | 1425 West Main Street, Walnut Ridge, AR 72476 | 2010-12-22 |
| Find all providers in zip 72476 | ||||
| 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 |
|---|---|---|---|---|
| 1295822708 | John T Mchaney | Optometrist | 1014 W. Main St, Walnut Ridge, AR 72476 | 2006-10-06 |
| 1982760955 | Kelly G Ross Od Pa | Optometrist | 1014 W Main St, Walnut Ridge, AR 72476-1004 | 2006-12-28 |
| 1215025119 | Southern Eye Associates, Ltd | Optometrist | 1014 W Main St, Walnut Ridge, AR 72476-1004 | 2006-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497373088 | Taylor Renz | Optometrist | 1225 W Beebe Capps Expy, Searcy, AR 72143-5179 | 2020-07-09 |
| 1932733185 | Ashley Mcgee | Optometrist | 723 Falls Blvd S Ste A, Wynne, AR 72396-3509 | 2020-02-26 |
| 1972144566 | Randy Bell Od Pllc | Optometrist | 101 W Walnut St, Rogers, AR 72756-6662 | 2019-10-04 |
| 1881241792 | Radiant Eye Care Optometric Corporation | Optometrist | 1210 Jtl Pkwy E Ste 103, Springdale, AR 72762-7019 | 2019-08-25 |
| 1457905903 | Heather Snyder | Optometrist | 1021 South Waldron Road, Fort Smith, AR 72903 | 2019-08-01 |
| 1568024230 | Lawrence Allen King IIi | Optometrist | 4300 Rogers Ave Ste 46, Fort Smith, AR 72903-3152 | 2019-07-02 |
| 1306406269 | Idell Marie Mitchell | Optometrist | Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 | 2019-06-13 |
| 1417413717 | Med Southwest, Pllc | Optometrist | 114 E 49th St, Texarkana, AR 71854-2117 | 2019-02-12 |
| 1588120877 | Med Southwest, Pllc | Optometrist | 2510 N Hervey St, Hope, AR 71801-8419 | 2019-02-12 |
| 1093279275 | Piper's Vision Xpress, LLC | Optometrist | 50 Paul Wood Lane, Mountian Home, AR 72653 | 2019-01-22 |
| Find all providers with the same taxonomy | ||||
| City | WALNUT RIDGE |
| Zip Code | 72476 |
Please comment or provide details below to improve the information on DR. KELLY G ROSS.
| 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.