Individual provider Active NPI

Carlye Elizabeth Kennedy, OD

  • Optometrist
  • Atoka, OK
National Provider Identifier
1831010107
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3348 Issued in OK
Practice address
1722 W Liberty Rd
Atoka, OK 74525-1705
Phone
(580) 292-0144
Fax
(580) 292-0142
NPI assigned
Jul 23, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3348 OK Primary

Addresses

Primary practice location

1722 W Liberty Rd
Atoka, OK 74525-1705

Mailing address

1400 E Wade Watts Ave
McAlester, OK 74501-5652
Phone (918) 429-1400

Other practice location 1

1400 E Wade Watts Ave
McAlester, OK 74501-5652
Phone (918) 429-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Eyecare LLC Optometrist Past Accepting new patients
Kennedy Eyecare LLC Optometrist PastSince Mar 5, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1784764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1831010107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E WADE WATTS AVE",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745015652",
            "telephone_number": "918-429-1400",
            "fax_number": "918-429-1403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 W LIBERTY RD",
            "city": "ATOKA",
            "state": "OK",
            "postal_code": "745251705",
            "telephone_number": "580-292-0144",
            "fax_number": "580-292-0142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 E Wade Watts Ave",
            "address_purpose": "LOCATION",
            "city": "McAlester",
            "state": "OK",
            "postal_code": "745015652",
            "country_code": "US",
            "telephone_number": "918-429-1400",
            "fax_number": "918-429-1403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "CARLYE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-23",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atoka, OK

Sources for this page

Verify at the official NPI Registry.