Active NPI
Richard Kennedy, O.D.
- Optometrist
- Barstow, CA
National Provider Identifier
1154313633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5803T
- Practice address
- 945 Armory Rd Ste C
Barstow, CA 92311-5478 - Phone
- (760) 252-7518
- Fax
- (760) 252-7510
- NPI assigned
- Aug 19, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5803T | CA | Primary |
Addresses
Primary practice location
945 Armory Rd Ste C
Barstow, CA 92311-5478
Mailing address
945 Armory Rd Ste C
Barstow, CA 92311-5478
Phone (760) 252-7518
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5803T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Choice Physicians Network, Inc. | Past | Accepting new patients | |
| Saint John Hospital, Inc | Past | Accepting new patients | |
| UCLA Medical Group | Past | Accepting new patients | |
| Corwin Medical Group Inc Ipa | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Exclusive Provider Organization
- Apple Valley, CA
- NPI 1639401987
-
- Exclusive Provider Organization
- Apple Valley, CA
- NPI 1821018433
-
- Internal Medicine Physician
- Los Angeles, CA
- NPI 1043427248
-
- General Acute Care Hospital
- Leavenworth, KS
- NPI 1295735397
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407801600000",
"number": "1154313633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "945 ARMORY RD STE C",
"city": "BARSTOW",
"state": "CA",
"postal_code": "923115478",
"telephone_number": "760-252-7518",
"fax_number": "760-252-7510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "945 ARMORY RD STE C",
"city": "BARSTOW",
"state": "CA",
"postal_code": "923115478",
"telephone_number": "760-252-7518",
"fax_number": "760-252-7510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "RICHARD",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-19",
"last_updated": "2014-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "5803T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Barstow, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.