Scott A Kennedy, OD

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

OEG000659 Issued in PA

Practice address

122 N Franklin St
Titusville, PA 16354-1761

Phone

(814) 827-7931

Fax

(814) 827-0746

NPI assigned

Apr 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Vision Source Meadville, LLC

  • Optometrist
  • Meadville, PA
  • NPI 1134475007
  NPD

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1922060599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1073 S MAIN ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163353129",
            "telephone_number": "814-333-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 N FRANKLIN ST",
            "city": "TITUSVILLE",
            "state": "PA",
            "postal_code": "163541761",
            "telephone_number": "814-827-7931",
            "fax_number": "814-827-0746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "SCOTT",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "PA",
            "license": "OEG000659",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "PA",
            "license": "OEG000659",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "PA",
            "license": "OEG000659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terrie Gwin, CRNP
• Taylor Heasley, LPC
• Brandi Hudson, CRNP
• James B Wilkens Jr. M.D. P.C.
• Karen A Judy
• Evelyn Kerr, RN
• Andrea M Kessler, PT & OT
• Keystone Rehabilitation Systems Inc
• Moiz Khan, DDS, MS
• Tosha Kight, RN

• Corneal and Contact Management Optometrist in Titusville, PA
• Providers in Titusville, PA by specialty
• Corneal and Contact Management Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.