Edward M Kenshock, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1799 Issued in NC

Practice address

1629 Owen Dr
Fayetteville, NC 28304-3456

Phone

(910) 484-2284

Fax

(910) 484-1673

NPI assigned

Jul 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cape Fear Eye Associates PAGroup PAC ID 3072519107, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

95.4 of 100Reported as group

Quality

100

Improvement activities

40

Cost

84.66

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: edward.kenshock.p1@direct.cfea.nextgenshare.com

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.

• Cape Fear Eye Associates PA

  • Ophthalmology Physician
  • Fayetteville, NC
  • NPI 1962456343

  Optometrist

  Medicare reassignment Care Compare group NPD
• Cape Fear Eye Associates

  • Optician
  • Fayetteville, NC
  • NPI 1588781108
  NPD
• Susan C Whitaker OD PA

  • Optometrist
  • Carthage, NC
  • NPI 1962605105
  NPD (past)

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1417980913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 METROMEDICAL DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043861",
            "telephone_number": "910-484-2284",
            "fax_number": "910-484-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043456",
            "telephone_number": "910-484-2284",
            "fax_number": "910-484-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENSHOCK",
        "first_name": "EDWARD",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89093JU",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Kennedy, BCBA
• Michelle Ann Kennedy, OTD, OTR/L
• Roselyn Brooks Kennedy, DMD
• Jacqueline McKoy Kenney
• Malinda Marie Kennison, DPT
• John N Kent, DMD
• Lella E Kenworthy
• Jennifer Loving Kerekes, PSC, LCMHC-A
• Brian Tyler Kern, DO
• Connie Kern, NCC, LCMHC, NBCR

• Optometrist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.