Kennedy Morgan Simmons, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3953 Issued in MN

Practice address

2950 Curve Crest Blvd W
Stillwater, MN 55082-5085

Phone

(651) 275-3000

NPI assigned

May 23, 2024

Last updated

Jul 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Church Health Center of Memphis IncGroup PAC ID 7517863392, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: kennedy.simmonsod.p1@direct.churchhealthcenter.nextgenshare.com
• Direct secure messaging: kennedy.simmonsod.p2@direct.associated-eyecare.nextgenshare.com

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.

• Church Health Center of Memphis Inc

  dba Church Health

  • Primary Care Clinic/Center
  • Memphis, TN
  • NPI 1427030907
  Medicare reassignment Care Compare group NPD
• Associated Eye Care LTD

  • Optometrist
  • Stillwater, MN
  • NPI 1881699197
  Medicare reassignment NPD
• Associated Eye Care Optical LLC

  • Eyewear Supplier
  • Hudson, WI
  • NPI 1205214236
  NPD (past)

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

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1114766607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 CURVE CREST BLVD W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550825085",
            "telephone_number": "651-275-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 CURVE CREST BLVD W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550825085",
            "telephone_number": "651-275-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "KENNEDY",
        "middle_name": "MORGAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-07-08",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Merrily Shipe, LPC
• Nathan Shjerve
• Jennifer A Siegle, PA
• Chloe L Sieling, DNP, APRN, FNP-C
• Kari R N Sikkink, MD
• Lauren Miyoko Simpson
• Erin E Simunds, PT
• Swati Singh
• Camille Marie Skarvan, PA-C
• Linda Luene Skinaway, RN

• Optometrist in Stillwater, MN
• Providers in Stillwater, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.