Organization Active NPI

Lifetime Eyecare

  • Optometrist
  • Spearfish, SD
National Provider Identifier
1346362373
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
LIFETIME EYECARE
Practice address
1230 North Ave
Suite #3
Spearfish, SD 57783-3028
Phone
(605) 642-4656
NPI assigned
Apr 3, 2007
Last updated
Aug 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Authorized official

Name
Scott Kennedy, O.D.NPI 1871561795
Title
Dr.
Phone
(605) 642-4656

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

1230 North Ave
Suite #3
Spearfish, SD 57783-3028

Mailing address

1230 North Ave Ste 3
Spearfish, SD 57783-1572
Phone (605) 642-4656

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Scott.Kennedy@direct.revolutionehr.com Direct
Direct Messaging Address terry.wolthuis@direct.revolutionehr.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040529000021 SD Part B Supplier - Clinic/Group Practice 7517948011 Receives reassigned benefits from 2 practitioners
Practice locations: Spearfish, SD
O20100930090362 SD DME Supplier - Physician - Optometrist 7517948011 Practice locations: Spearfish, SD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Lifetime Eyecare1230 North Ave, Spearfish, SD 57783-1572(605) 642-4656 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

Locations

1230 North Ave
Ste 3
Spearfish, SD 57783
Phone (605) 642-4656

Interoperability endpoints

  • Direct secure messaging: scott.kennedy@direct.revolutionehr.com
  • Direct secure messaging: terry.wolthuis@direct.revolutionehr.com

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1346362373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 NORTH AVE STE 3",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577831572",
            "telephone_number": "605-642-4656",
            "fax_number": "605-717-2413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 NORTH AVE",
            "address_2": "SUITE #3",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577833028",
            "telephone_number": "605-642-4656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "DR.",
        "authorized_official_telephone_number": "605-642-4656",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Scott.Kennedy@direct.revolutionehr.com",
            "affiliation": "N",
            "endpointDescription": "Scott.Kennedy@direct.revolutionehr.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "1230 North Ave",
            "address_2": "Suite #3",
            "city": "Spearfish",
            "state": "SD",
            "country_code": "US",
            "postal_code": "577833028",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "terry.wolthuis@direct.revolutionehr.com",
            "affiliation": "N",
            "endpointDescription": "terry.wolthuis@direct.revolutionehr.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "1230 North Ave",
            "address_2": "Suite #3",
            "city": "Spearfish",
            "state": "SD",
            "country_code": "US",
            "postal_code": "577833028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spearfish, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.