Kennedy Vision PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC4146 Issued in FL

Legal business name

KENNEDY VISION PA

Practice address

18503 Pines Blvd Ste 205
Pembroke Pines, FL 33029-1405

Phone

(954) 430-8330

Fax

(954) 430-3638

NPI assigned

Mar 13, 2013

Organization subpart

No

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

Authorized official

Name

Caleb Joseph Kennedy, ODNPI 1205064334

Title

Optometrist/Owner

Phone

(954) 430-8330

Specialties & licenses 1

Addresses

Other names 1

• The Family Eye Site Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Caleb Joseph Kennedy, O.D.

  • Optometrist
  • Pembroke Pines, FL
  • NPI 1205064334
  Medicare reassignment NPD Authorized official
• Scott M. Pearl, O.D.

  • Optometrist
  • St Augustine, FL
  • NPI 1467452474
  NPD

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

{
    "created_epoch": "1363132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748390400000",
    "number": "1104167345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18503 PINES BLVD STE 205",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330291405",
            "telephone_number": "954-430-8330",
            "fax_number": "954-430-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18503 PINES BLVD STE 205",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330291405",
            "telephone_number": "954-430-8330",
            "fax_number": "954-430-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY VISION PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-13",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "CALEB",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "954-430-8330",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Family Eye Site",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• KC Wellness Nurse Registry Inc
• Ashley D Keen
• Nicole Tahnee Keet
• Faith Brunhille Kellier-Dunn, AGPCNP-BC
• Ryan Kelly, MD
• Caleb Joseph Kennedy, O.D.
• Christina Kerns, CRNA
• Joseph A Kesselman, O.D.
• Leonard Paul Kessler
• Jessica Ketterer, PH.D.

• Optometrist in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.