Individual provider Active NPI

Lindsey Kennedy, O.D.

  • Optometrist
  • Wamego, KS
National Provider Identifier
1972057677
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2185 Issued in KS
Practice address
1405 W US Highway 24
Wamego, KS 66547-1256
Phone
(785) 456-8900
NPI assigned
Aug 10, 2016
Last updated
May 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9366 TX
Optometrist 152W00000X 33457 CA
Optometrist 152W00000X 2185 KS Primary

Addresses

Primary practice location

1405 W US Highway 24
Wamego, KS 66547-1256

Mailing address

55524 Reese Dr Apt 1
Fort Riley, KS 66442-2456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, KS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180613002799 TX Practitioner - Optometry 2961772520 Reassigns benefits to 1 organization
I20230525002429 KS Practitioner - Optometry 2961772520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kyler Knobbe OD LLCGroup PAC ID 1951694298, 3 clinicians

Practice addresses (Care Compare)

1405 W US Hwy 24
Wamego, KS 66547-1256
Phone (785) 456-8900

Merit-based Incentive Payment System (MIPS)

Final score
88.77 of 100Reported as group
Quality
77.54
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9366TXMDProfessional Counselor
33457CAMDChiropractor
2185KSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Blair and Ellis P.a. Optometrist CurrentSince Jun 1, 2020 Accepting new patients
Mark Bettencourt, O.D. PC Optometrist CurrentSince Jun 12, 2023 Accepting new patients
Kyler Knobbe, OD, LLC Optometrist CurrentSince Jun 12, 2023 Accepting new patients

Locations

930 Hayes Dr
Ste D
Manhattan, KS 66502
Phone (785) 539-2020

1405 W US Highway 24
Wamego, KS 66547
Phone (785) 456-8900

3800 N Mesa St
Ste B1
El Paso, TX 79902
Phone (915) 533-1811

Interoperability endpoints

  • Direct secure messaging: lindsey.kennedy@direct.revolutionehr.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1972057677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55524 REESE DR APT 1",
            "city": "FORT RILEY",
            "state": "KS",
            "postal_code": "664422456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 W US HIGHWAY 24",
            "city": "WAMEGO",
            "state": "KS",
            "postal_code": "665471256",
            "telephone_number": "785-456-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "LINDSEY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9366",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33457",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "2185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wamego, KS

Sources for this page

Verify at the official NPI Registry.