Maya Juliana Kennon, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

10945 Issued in TX

Practice address

2112 SW H K Dodgen Loop Ste 135
Temple, TX 76504-7011

Phone

(254) 598-7579

NPI assigned

Jul 19, 2023

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• National Vision Inc

  • Optometrist
  • Temple, TX
  • NPI 1336869627
  NPD

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1932889524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 SW H K DODGEN LOOP STE 135",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765047011",
            "telephone_number": "254-598-7579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 SW H K DODGEN LOOP STE 135",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765047011",
            "telephone_number": "254-598-7579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNON",
        "first_name": "MAYA",
        "middle_name": "JULIANA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jarred Kendziorski, DO
• Savannah Catherine Kenendy, COTA
• Jacob Kennedy
• Laura Kennedy, DO
• Taylor Jean Kennedy, MD
• Erin Lee Kern
• Mollie Christina Kerr
• Matthew J Kerrigan, MD
• Thomas Edward Kershaw, LCSW
• Nithin Kesireddy, MD

• Optometrist in Temple, TX
• Providers in Temple, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.