Individual provider Active NPI

Kendra Kappes

  • Optometrist
  • Bradenton, FL
National Provider Identifier
1265286439
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2889 Issued in AZ
Practice address
7507 Haddington CV
Bradenton, FL 34202-5915
Phone
(920) 205-5747
NPI assigned
Apr 15, 2024
Last updated
Jul 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Optometrist 152W00000X 2889 AZ Primary

Addresses

Primary practice location

7507 Haddington CV
Bradenton, FL 34202-5915

Mailing address

7507 Haddington CV
Bradenton, FL 34202-5915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250715003675 AZ Practitioner - Optometry 9931614211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Complete Vision Care PLLCGroup PAC ID 9931553831, 3 clinicians

Practice addresses (Care Compare)

1100 N Broad St
Suite B
Globe, AZ 85501-2700
Phone (928) 425-5203

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2889AZMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Vision Care PLLC Optometrist CurrentSince Jul 1, 2025 Accepting new patients
Complete Vision Care PLLC Optometrist PastSince Dec 8, 2024 Accepting new patients

Locations

1100 N Broad St
Ste B
Globe, AZ 85501
Phone (928) 425-0322

220 E Southern Ave
Phoenix, AZ 85040

Organizations & group practices 2

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": "1713139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1265286439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7507 HADDINGTON CV",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342025915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7507 HADDINGTON CV",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342025915",
            "telephone_number": "920-205-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPPES",
        "first_name": "KENDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-15",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "2889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.