Active NPI
Lynne K Martin, O.D.
- Optometrist
- Round Rock, TX
National Provider Identifier
1396834115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4499T
- Practice address
- 2701 S Interstate 35
Round Rock, TX 78664-7320 - Phone
- (512) 388-2600
- Fax
- (512) 388-2600
- NPI assigned
- Oct 11, 2006
- Last updated
- Mar 27, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4499T | TX | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | 4499T | TX |
Addresses
Primary practice location
2701 S Interstate 35
Round Rock, TX 78664-7320
Mailing address
1308 Arronimink Cir
Austin, TX 78746-6303
Phone (512) 785-0624
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019327801 | Medicaid | TX | |
| 920532 | Other | TX | BLOCK (CHIP & AMERIGROUP) |
| 26310 | Other | TX | MEDICAL EYE SERVICES |
| 64765 | Other | TX | SAFEGUARD |
| 47839 | Other | TX | DAVIS |
| 35403 | Other | TX | AVESIS |
| 47839 | Other | TX | DAVIS VISION |
| 26903 | Other | TX | SPECTERA |
Other names 1
- Dr. Eva Lynne Kennington
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4499T | TX | MD | Corneal and Contact Management Optometrist |
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, 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": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395878400000",
"number": "1396834115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1308 ARRONIMINK CIR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787466303",
"telephone_number": "512-785-0624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 S INTERSTATE 35",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786647320",
"telephone_number": "512-388-2600",
"fax_number": "512-388-2600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "LYNNE",
"middle_name": "K",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-11",
"last_updated": "2014-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "4499T",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "TX",
"license": "4499T",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "019327801",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLOCK (CHIP & AMERIGROUP)",
"identifier": "920532",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL EYE SERVICES",
"identifier": "26310",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SAFEGUARD",
"identifier": "64765",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DAVIS",
"identifier": "47839",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVESIS",
"identifier": "35403",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DAVIS VISION",
"identifier": "47839",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECTERA",
"identifier": "26903",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "EVA",
"last_name": "KENNINGTON",
"middle_name": "LYNNE",
"prefix": "DR.",
"credential": "O.D.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Round Rock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.