BRENDAN S KELLY (NPI# 1689873275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689873275 |
| Entity Type | Individual |
| Full Name | BRENDAN S KELLY |
| Credential | O.D. |
| Practice Address |
1717 University Dr S Fargo ND 58103-4939 |
| Mailing Address |
1720 University Dr S Fargo ND 58103-4940 |
| Practice Telephone | 7014615100 |
| Practice Fax Number | 7014615124 |
| Mailing Telephone | 7014615100 |
| Mailing Fax Number | 7014615124 |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2020-08-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 666 | ND | Eye and Vision Services Providers |
| N | 152W00000X | Optometrist | 2604 | CO | Eye and Vision Services Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1720 University Dr S, Fargo, ND 581034940 | 7014615100 | 7014615124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225154800 | Brendan Neubecker Kelly | Social Worker | 1118 Front Ave Nw Ste 1, Grand Rapids, MI 49504 | 2007-03-22 |
| 1942570114 | Brendan Kelly | Acupuncturist | 1 Mill St, Suite 305, Burlington, VT 05401-1530 | 2012-01-05 |
| 1629222781 | Brendan S Kelly | Hospitalist | 1925 Pacific Ave, Atlantic City, NJ 08401-6713 | 2008-11-15 |
| 1376705798 | Brendan Sean Kelly | Internal Medicine | Ku Medical Center Div of General &, 3901 Rainbow Blvd, Ms 1020, Kansas City, KS 66160-0001 | 2008-06-26 |
| 1598924532 | Brendan Joseph Kelly | Internal Medicine | 3400 Spruce Street, Philadelphia, PA 19104-4206 | 2008-06-05 |
| 1033233192 | Brendan Patrick Kelly | Pediatrics | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2007-03-16 |
| Street Address |
1717 UNIVERSITY DR S |
| City | FARGO |
| State | ND |
| Zip Code | 58103-4939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659373876 | Jennifer R. Olbum | Ophthalmology | 1717 University Dr S, Fargo, ND 58103-4939 | 2005-06-01 |
| 1750949855 | Chelsea Marie Norman | Physician Assistant | 1717 University Dr S, Fargo, ND 58103-4939 | 2019-06-03 |
| 1245726363 | Anna Pauline Wilson | Nurse Practitioner | 1717 University Dr S, Fargo, ND 58103-4939 | 2018-07-02 |
| 1598262545 | Leann Elizabeth Czapiewski | Dietitian, Registered | 1717 University Dr S, Fargo, ND 58103-4939 | 2018-04-06 |
| 1881063006 | Meagen Anderson | Physician Assistant | 1717 University Dr S, Fargo, ND 58103-4939 | 2015-09-17 |
| 1972938843 | Amber D Strobel | Nurse Practitioner | 1717 University Dr S, Fargo, ND 58103-4939 | 2013-09-10 |
| 1750632352 | Brianna Srnsky | Dietitian, Registered | 1717 University Dr S, Fargo, ND 58103-4939 | 2012-09-24 |
| 1790060846 | Alison Rae Moses | Optometrist | 1717 University Dr S, Fargo, ND 58103-4939 | 2011-10-19 |
| 1215211750 | Kelsey R Herrick | Dietitian, Registered | 1717 University Dr S, Fargo, ND 58103-4939 | 2011-10-03 |
| 1891075198 | Sanford Medical Center Fargo | Eyewear Supplier (Equipment, not the service) | 1717 University Dr S, Fargo, ND 58103-4939 | 2011-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
| Find all providers in zip 58103 | ||||
| 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 |
|---|---|---|---|---|
| 1447879663 | Lumen Vision PC | Optometrist | 5120 Prosperity Way S Ste 114, Fargo, ND 58104-7568 | 2020-04-09 |
| 1376194472 | Vanessa Manlove | Optometrist | 1902 25th Ave S, Fargo, ND 58103-5128 | 2019-09-20 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1720447808 | Eyes On Broadway LLC | Optometrist | 311 Broadway N, Fargo, ND 58102-4714 | 2016-02-17 |
| 1386028777 | Carissa Guler | Optometrist | 3902 13th Ave S Ste 256, Fargo, ND 58103-3357 | 2015-07-15 |
| 1306139266 | Stacey Archibald | Optometrist | 3409 45th St S Ste 100, Fargo, ND 58104-8970 | 2011-05-25 |
| 1407187065 | Selina Bjorlie | Optometrist | 2826 Lilac Ln N, Fargo, ND 58102-1703 | 2010-01-21 |
| 1073840336 | Kristin F Engstrom, O.d. PC | Optometrist | 3757 55th Ave S, Fargo, ND 58104 | 2009-11-06 |
| 1679808752 | Erin L Barrett | Optometrist | 3265 45th St S Ste 104, Fargo, ND 58104-7930 | 2009-10-07 |
| 1235326398 | Dr. L.r. Masciarelli & Associates Optometry | Optometrist | 4302 13th Ave S, Fargo, ND 58103-3395 | 2007-10-02 |
| Find all providers in FARGO | ||||
Please comment or provide details below to improve the information on BRENDAN S KELLY.
| 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.