Active NPI
Nancy J. Kennedy, O.D.
- Corneal and Contact Management Optometrist
- Olympia, WA
National Provider Identifier
1508921685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Corneal and Contact Management Optometrist
- License
- OD00001331
- Practice address
- 700 Lilly Rd NE
Olympia, WA 98506-5115 - Phone
- (360) 923-7000
- NPI assigned
- Dec 27, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | OD00001331 | WA | Primary |
Addresses
Primary practice location
700 Lilly Rd NE
Olympia, WA 98506-5115
Mailing address
PO Box 34584
Seattle, WA 98124-1584
Phone (509) 241-7349
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8100521 | Medicaid | WA |
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 |
|---|---|---|---|
| OD00001331 | WA | MD | Corneal and Contact Management Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210204800000",
"number": "1508921685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 34584",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981241584",
"telephone_number": "509-241-7349",
"fax_number": "509-241-7628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 LILLY RD NE",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065115",
"telephone_number": "360-923-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "NANCY",
"middle_name": "J.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-27",
"last_updated": "2008-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "WA",
"license": "OD00001331",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8100521",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.