Krystle Lynn Kennedy, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1327 Issued in NE

Practice address

7615 Dodge St
Omaha, NE 68114

Phone

(402) 391-2375

NPI assigned

Jul 11, 2009

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 NE

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Macarius & Daniel

  dba Stanton Optical

  • Eyewear Supplier
  • Omaha, NE
  • NPI 1548575574

  Optometrist

  NPD (past)
• Nebraska Physicians Eyecare Group, P.C.

  • Optometrist
  • Omaha, NE
  • NPI 1225508468
  NPD (past)

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

{
    "created_epoch": "1247270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1831328848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7615 DODGE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143634",
            "telephone_number": "402-391-2375",
            "fax_number": "402-397-0371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7615 DODGE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68114",
            "telephone_number": "402-391-2375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10504 S 15th St",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "NE",
            "postal_code": "681234084",
            "country_code": "US",
            "telephone_number": "402-292-0651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KRYSTLE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-11",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eugene Todd Kennedy
• Heather Kennedy, LMHP
• Jacqueline Kennedy
• Keara Lonergan Kennedy
• Ki-Aeja Kennedy
• Leah Renae Kennedy
• Madeline Kennedy
• Marti Kennedy, PA-C
• Shalena Kennedy
• Sheila Laurren Kennedy

• Optometrist in Omaha, NE
• Providers in Omaha, NE by specialty
• Optometrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.