Organization Active NPI

Summit Vision Care Inc

  • Optometrist
  • Erie, CO
National Provider Identifier
1821318627
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1750 Issued in CO
Legal business name
SUMMIT VISION CARE INC
Practice address
619 Mitchell Way
Erie, CO 80516-5436
Phone
(303) 828-1512
NPI assigned
Jun 3, 2010
Last updated
Jul 1, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Authorized official

Name
Dr. Doug Kennedy, O.D.
Title
Optometrist
Phone
(303) 828-1512

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1750 CO Primary

Addresses

Primary practice location

619 Mitchell Way
Erie, CO 80516-5436

Mailing address

615 Mitchell Way Ste 103
Erie, CO 80516-5438
Phone (303) 828-1512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100831000711 CO Part B Supplier - Clinic/Group Practice 5698899482 Receives reassigned benefits from 4 practitioners
Practice locations: Erie, CO

National Provider Directory

National Provider Directory

Locations

615 Mitchell Way
Ste 103
Erie, CO 80516
Phone (303) 828-1512

619 Mitchell Way
Erie, CO 80516
Phone (303) 828-1512

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782864000000",
    "number": "1821318627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 MITCHELL WAY STE 103",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805165438",
            "telephone_number": "303-828-1512",
            "fax_number": "303-828-1514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 MITCHELL WAY",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805165436",
            "telephone_number": "303-828-1512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT VISION CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-03",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "303-828-1512",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.