Douglas W Kennedy, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1750 Issued in CO

Practice address

619 Mitchell Way
Erie, CO 80516-5436

Phone

(303) 828-1512

Fax

(303) 828-1514

NPI assigned

Feb 21, 2007

Sex

Male

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 CO

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Vision Care IncGroup PAC ID 5698899482, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Summit Vision Care Inc

  • Optometrist
  • Erie, CO
  • NPI 1821318627
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1912042466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 MITCHELL WAY",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805165436",
            "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",
            "fax_number": "303-828-1514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 Folsom St Ste C",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803043768",
            "country_code": "US",
            "telephone_number": "303-442-6260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "DOUGLAS",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin K. Cole (Great Day Chiropractic & Wellness Center)
• Tenzin Kalden, MSN, AGNP-C
• Eugene C Kang, MD, DMD
• Denise Sharen Kawecki, FNP-C
• Clare Kelway, DIHOM NTP BHCN
• Karen Kepart, R.N.
• Kerr Chiropractic Clinic PLC
• Amanda Kilen, PHARMD
• Colleen Kimball, DDS
• Jamie King, LCSW

• Optometrist in Erie, CO
• Providers in Erie, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.