Kenmore Eyecare Center

Primary specialty

OptometristTaxonomy code 152W00000X

License

2366 Issued in OK

Legal business name

KENMORE EYECARE CENTER

Practice address

513 N Telephone Rd
Moore, OK 73160-4938

Phone

(405) 799-3030

Fax

(405) 799-3737

NPI assigned

Dec 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Todd Alan Kenmore, O.D.NPI 1508870437

Title

President

Phone

(405) 799-3030

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Todd Alan Kenmore, O.D.

  • Optometrist
  • Moore, OK
  • NPI 1508870437
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202342400000",
    "number": "1356524011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 N TELEPHONE RD",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731604938",
            "telephone_number": "405-799-3030",
            "fax_number": "405-799-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 N TELEPHONE RD",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731604938",
            "telephone_number": "405-799-3030",
            "fax_number": "405-799-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENMORE EYECARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2008-02-07",
        "status": "A",
        "authorized_official_last_name": "KENMORE",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-799-3030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2366",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OK",
            "license": "2366",
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "OK",
            "license": "2366",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200019180B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edna C Kelly, LPC - CANDIDATE
• Marcus Jerome Kelly
• Mistye Kelly
• Ida S Kemunto Magati
• Ella Sue Kendrick
• Todd Alan Kenmore, O.D.
• Dave Sanford Kerby, PHD
• Landon Wade Kersey, ATC, LAT
• Ketamine Ok LLC
• Cerissa Kalani Key, D.O.

• Optometrist in Moore, OK
• Providers in Moore, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.