Jordan Lyn Kennedy, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

6782 Issued in FL

Practice address

3200 S University Dr BLDG 1402
Davie, FL 33328-2018

Phone

(954) 262-4235

Fax

(954) 262-3904

NPI assigned

Jul 3, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nova Southeastern University IncGroup PAC ID 4486568896, 97 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nova Southeastern University, Inc

  • Optometrist
  • Fort Lauderdale, FL
  • NPI 1700924511
  Medicare reassignment Care Compare group NPD
• Nova Southeastern University Inc.

  • Clinical Medical Laboratory
  • Fort Lauderdale, FL
  • NPI 1770533390
  NPD
• Nova Southeastern University, Inc

  • Audiologist
  • Davie, FL
  • NPI 1710052766
  NPD
• Nova Southeastern University, Inc

  • Family Medicine Physician
  • Davie, FL
  • NPI 1447345517
  NPD (past)
• Nova Southeastern University, Inc

  • Optometrist
  • Davie, FL
  • NPI 1588802169
  NPD (past)

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

{
    "created_epoch": "1751500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1437049376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 290370",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333290370",
            "telephone_number": "954-262-4397",
            "fax_number": "954-262-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR BLDG 1402",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-4235",
            "fax_number": "954-262-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JORDAN",
        "middle_name": "LYN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-03",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "6782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hailey Suzanne Kelderhouse
• Peter Allen Keller, DDS
• Kelli Richard-Lopez LCSW
• Denise Kelly
• Maylen Kelly
• Tarah Lynn Kennedy, PHARM D
• Wren Kerce
• Dina Kershteyn
• Ruth Kervin
• Marc M Kesselman, D.O.

• Optometrist in Davie, FL
• Providers in Davie, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2025; 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.