NPIMap

Organization Active NPI

Kennedy Eye Associates

  • Optometrist
  • Saint Paul, MN
National Provider Identifier
1013127281
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
KENNEDY EYE ASSOCIATES
Practice address
1790 Lexington Ave N
Saint Paul, MN 55113-6167
Phone
(651) 488-6771
Fax
(651) 488-5576
NPI assigned
May 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Authorized official

Name
Robert B Kennedy, O.D., F.A.A.O.
Title
President
Phone
(651) 488-6771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1790 Lexington Ave N
Saint Paul, MN 55113-6167

Mailing address

1790 Lexington Ave N
Saint Paul, MN 55113-6167
Phone (651) 488-6771

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1013127281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 LEXINGTON AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551136167",
            "telephone_number": "651-488-6771",
            "fax_number": "651-488-5576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 LEXINGTON AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551136167",
            "telephone_number": "651-488-6771",
            "fax_number": "651-488-5576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY EYE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-488-6771",
        "authorized_official_credential": "O.D., F.A.A.O."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.