Individual provider Active NPI

Judy Smith Kandel, OD

  • Optometrist
  • Arlington, WA
National Provider Identifier
1114070299
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00001491 Issued in WA
Practice address
16410 Smokey Point Blvd
#101
Arlington, WA 98223-8415
Phone
(360) 653-8711
NPI assigned
Jan 19, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00001491 WA Primary

Addresses

Primary practice location

16410 Smokey Point Blvd
#101
Arlington, WA 98223-8415

Mailing address

16410 Smokey Point Blvd
#101
Arlington, WA 98223-8415
Phone (360) 653-8711

Other identifiers 1

IdentifierTypeStateIssuer
2088904MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1491WAMDClinical Psychologist
OD00001491WAMDOptometrist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114070299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16410 SMOKEY POINT BLVD",
            "address_2": "#101",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982238415",
            "telephone_number": "360-653-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16410 SMOKEY POINT BLVD",
            "address_2": "#101",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982238415",
            "telephone_number": "360-653-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANDEL",
        "first_name": "JUDY",
        "middle_name": "SMITH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2088904",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.