Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Kelly Boucher, OD

Individual provider Optometrist · NPI 1528476207

Dr. Kelly Boucher, OD is an Optometry in Oklahoma City, Oklahoma. Graduated from Indiana University - School of Optometry in 2014, 12 years ago. Practices with Lawton Indian Hospital, a 127-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
12
Trained at
Indiana University - School of Optometry
Licensed in
OK
In the registry since
2014
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

4913 W Reno Ave
Oklahoma City, OK 73127-6339
Phone: (405) 948-4900
Fax: (405) 948-4933
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 2802 (OK)

Record details

NPI number1528476207
Entity typeIndividual (Type 1)
GenderFemale
Credentials OD
Sole proprietorYes
NPI enumeratedJuly 25, 2014
Last updated in NPPESJanuary 11, 2021
Certification dateJanuary 11, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolINDIANA UNIVERSITY - SCHOOL OF OPTOMETRY
Graduated 2014 (12 years in practice)
Group practice Lawton Indian Hospital — 127 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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