Active NPI
Terry L. Kennedy, OPTICIAN
- Optician
- Middletown, KY
National Provider Identifier
1164551644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- #299
- Practice address
- 121 Village SQ
Middletown, KY 40243-1420 - Phone
- (502) 245-7491
- Fax
- (502) 245-0581
- NPI assigned
- Mar 2, 2007
- 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | #299 | KY | Primary |
Addresses
Primary practice location
121 Village SQ
Middletown, KY 40243-1420
Mailing address
121 Village SQ
Middletown, KY 40243-1420
Phone (502) 245-7491
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| #299 | KY | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202688000000",
"number": "1164551644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 VILLAGE SQ",
"city": "MIDDLETOWN",
"state": "KY",
"postal_code": "402431420",
"telephone_number": "502-245-7491",
"fax_number": "502-245-0581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 VILLAGE SQ",
"city": "MIDDLETOWN",
"state": "KY",
"postal_code": "402431420",
"telephone_number": "502-245-7491",
"fax_number": "502-245-0581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "TERRY",
"middle_name": "L.",
"name_prefix": "Mr.",
"credential": "OPTICIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-02",
"last_updated": "2008-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "KY",
"license": "#299",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.