Kennedy & Young Optometry

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

KENNEDY & YOUNG OPTOMETRY

Doing business as

Valley Optometric Group

Practice address

1401 Sylvan Ave
Modesto, CA 95355-1367

Phone

(209) 527-6640

Fax

(209) 527-5489

NPI assigned

May 3, 2007

Last updated

Oct 5, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Trisha Frick

Title

Billing Specialist

Phone

(209) 527-6640

Specialties & licenses 1

Addresses

Other names 1

• Valley Optometric Group Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 5

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.

• Warren Leigh Kennedy, OD

  • Optometrist
  • Modesto, CA
  • NPI 1629069307
  Medicare reassignment Care Compare group NPD
• Michael Torossian, OD

  • Optometrist
  • Turlock, CA
  • NPI 1215677547
  Medicare reassignment Care Compare group NPD
• Brandon Wong, O.D.

  • Optometrist
  • Stockton, CA
  • NPI 1871045955
  Medicare reassignment Care Compare group NPD
• David Lawrence Gallagher, O.D.

  • Optometrist
  • Modesto, CA
  • NPI 1548259518
  NPD (past)
• Laura Mae Young, OD

  • Optometrist
  • Modesto, CA
  • NPI 1710968698
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1912119942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 SYLVAN AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551367",
            "telephone_number": "209-527-6640",
            "fax_number": "209-527-5489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 SYLVAN AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551367",
            "telephone_number": "209-527-6640",
            "fax_number": "209-527-5489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY & YOUNG OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2022-10-05",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "FRICK",
        "authorized_official_first_name": "TRISHA",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "209-527-6640"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Optometric Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valley Optometric Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffrey R Kemp, MS, DABR
• James Kempf
• Kimberly Kendall
• Richard Kendrick, M.D,
• Kennedy & Young Optometry (Valley Optometric Group)
• Barbara Kennedy-Funtila, MD
• Donavan Kennedy
• Warren Leigh Kennedy, OD
• Kenneth D Thompson DDS Inc
• Jennifer Jo'L Kennon

• Optometrist in Modesto, CA
• Providers in Modesto, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; 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.