Active NPI
Paul Kennedy, L.D.O.
- Optician
- Savannah, GA
National Provider Identifier
1376927186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- LDO001911
- Practice address
- 2 E Jackson Blvd
Savannah, GA 31405-5810 - Phone
- (912) 352-2953
- Fax
- (912) 352-7946
- NPI assigned
- Jul 13, 2015
- 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 | LDO001911 | GA | Primary |
Addresses
Primary practice location
2 E Jackson Blvd
Savannah, GA 31405-5810
Mailing address
2 E Jackson Blvd
Savannah, GA 31405-5810
Phone (912) 352-2953
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 |
|---|---|---|---|
| LDO001911 | GA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436745600000",
"number": "1376927186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 E JACKSON BLVD",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314055810",
"telephone_number": "912-352-2953",
"fax_number": "912-352-7946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 E JACKSON BLVD",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314055810",
"telephone_number": "912-352-2953",
"fax_number": "912-352-7946"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "PAUL",
"name_prefix": "Mr.",
"credential": "L.D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-13",
"last_updated": "2015-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "GA",
"license": "LDO001911",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Savannah, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.