Individual provider Active NPI

Jordan Lynn Kennedy

  • Optometrist
  • Nashua, NH
National Provider Identifier
1306512090
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1060 Issued in NH
Practice address
5 Coliseum Ave Ste 101
Nashua, NH 03063-3292
Phone
(603) 882-9800
Fax
(603) 882-0556
NPI assigned
Aug 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1060 NH Primary

Addresses

Primary practice location

5 Coliseum Ave Ste 101
Nashua, NH 03063-3292

Mailing address

5 Coliseum Ave Ste 101
Nashua, NH 03063-3292
Phone (603) 882-9800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20220829000556 NH Practitioner - Optometry 1557745361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nashua Eye Associates PA 19 clinicians

Practice addresses (Care Compare)

5 Coliseum Ave
Nashua, NH 03063-3292
Phone (603) 882-9800

Merit-based Incentive Payment System (MIPS)

Final score
88.97 of 100Reported as group
Quality
86.44
Promoting interoperability
100
Improvement activities
40
Cost
76.79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1060NHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nashua Eye Associates, P.a. Optometrist CurrentSince Sep 1, 2022 Accepting new patients

Locations

30 Lowell Rd
Hudson, NH 03051
Phone (603) 598-6400

555 Nashua St
Milford, NH 03055
Phone (603) 672-8800

5 Coliseum Ave
Nashua, NH 03063
Phone (603) 881-7141

5 Coliseum Ave
Ste 101
Nashua, NH 03063
Phone (603) 882-9800

Interoperability endpoints

  • Direct secure messaging: jordan.kennedy@nashuaeye.direct.eyemdemr.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1629504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1306512090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 COLISEUM AVE STE 101",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030633292",
            "telephone_number": "603-882-9800",
            "fax_number": "603-882-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 COLISEUM AVE STE 101",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030633292",
            "telephone_number": "603-882-9800",
            "fax_number": "603-882-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JORDAN",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-21",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "1060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

Verify at the official NPI Registry.