Scott a Kennedy OD PC

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

OEG000659 Issued in PA

Legal business name

SCOTT A KENNEDY OD PC

Practice address

122 N Franklin St
Titusville, PA 16354-1761

Phone

(814) 827-7931

NPI assigned

May 21, 2007

Organization subpart

No

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

Authorized official

Name

Scott A Kennedy, OD PC

Title

Sole Business Owner

Phone

(814) 827-7931

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Scott A Kennedy OD PC Former legal business name

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202169600000",
    "number": "1053529008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 285",
            "city": "TITUSVILLE",
            "state": "PA",
            "postal_code": "163540285",
            "telephone_number": "814-827-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 N FRANKLIN ST",
            "city": "TITUSVILLE",
            "state": "PA",
            "postal_code": "163541761",
            "telephone_number": "814-827-7931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT A KENNEDY OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2008-02-05",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SOLE BUSINESS OWNER",
        "authorized_official_telephone_number": "814-827-7931",
        "authorized_official_credential": "OD PC"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "PA",
            "license": "OEG000659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "410042928",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Scott A Kennedy OD PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Corneal and Contact Management Optometrist in Titusville, PA
• Providers in Titusville, PA by specialty
• Corneal and Contact Management Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.