Organization Active NPI

Jenny M. Kisner OD LLC

Doing business as Brookstone Eye Center

  • Optometrist
  • Wichita Falls, TX
National Provider Identifier
1891938163
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JENNY M. KISNER OD LLC
Doing business as
Brookstone Eye Center
Practice address
1508 Brook Ave
Wichita Falls, TX 76301-5604
Phone
(940) 761-2317
Fax
(940) 761-2992
NPI assigned
Apr 15, 2009
Last updated
Mar 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Authorized official

Name
Jenny M Kisner, O.D.NPI 1225016413
Title
Owner/Member
Phone
(940) 761-2317

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary
Ophthalmology Physician 207W00000X

Addresses

Primary practice location

1508 Brook Ave
Wichita Falls, TX 76301-5604

Mailing address

1508 Brook Ave
Wichita Falls, TX 76301-5604
Phone (940) 761-2317

Other identifiers 1

IdentifierTypeStateIssuer
208393302MedicaidTX

Other names 1

  • Brookstone Eye Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091212000027 TX Part B Supplier - Clinic/Group Practice 6406996032 Receives reassigned benefits from 3 practitioners
Practice locations: Wichita Falls, TX

National Provider Directory

National Provider Directory

Locations

1508 Brook Ave
Wichita Falls, TX 76301
Phone (940) 761-2317

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": "1239753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742860800000",
    "number": "1891938163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 BROOK AVE",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763015604",
            "telephone_number": "940-761-2317",
            "fax_number": "940-761-2992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 BROOK AVE",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763015604",
            "telephone_number": "940-761-2317",
            "fax_number": "940-761-2992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNY M. KISNER OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-15",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A",
        "authorized_official_last_name": "KISNER",
        "authorized_official_first_name": "JENNY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "940-761-2317",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208393302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookstone Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; 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.