Craig Kennedy, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2160 Issued in OK

Practice address

1400 E Wade Watts Ave
McAlester, OK 74501-5652

Phone

(918) 429-1400

Fax

(918) 429-1403

NPI assigned

Apr 10, 2006

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

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in OK

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

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kennedy Eyecare LLCGroup PAC ID 1557511367, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

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.

• Kennedy Eyecare LLC

  • Optometrist
  • McAlester, OK
  • NPI 1821343617
  Medicare reassignment Care Compare group NPD
• Kennedy Eyecare LLC

  • Optometrist
  • Checotah, OK
  • NPI 1033822135
  NPD Authorized official
• Kennedy Eyecare LLC

  • Optometrist
  • Atoka, OK
  • NPI 1770282444
  NPD Authorized official

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1992768113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E WADE WATTS AVE",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745015652",
            "telephone_number": "918-429-1400",
            "fax_number": "918-429-1403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E WADE WATTS AVE",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745015652",
            "telephone_number": "918-429-1400",
            "fax_number": "918-429-1403"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 W Okmulgee Ave",
            "address_purpose": "LOCATION",
            "city": "Checotah",
            "state": "OK",
            "postal_code": "744262408",
            "country_code": "US",
            "telephone_number": "918-473-2308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "CRAIG",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "0166707",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100763340B",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO DME",
            "identifier": "1324230001",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS (WPS)",
            "identifier": "74502A002",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STERLING OPTION 1",
            "identifier": "U56560",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE",
            "identifier": "731310891006",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE SOUTH",
            "identifier": "731310891028",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Carel Kellum, MHR/BHRS
• Carissa Kemp, LPC
• Cindy J Kemp
• Jason Kemp, LPN
• Kennedy Eyecare LLC
• Warren McKinley Kerby
• Marian Kerns
• Alisha Dawn Ketchum
• Abdolkarim Khorasanchian, MD
• Ki Bois Community Action Foundation (The Oaks Rehabilitative Services Center)

• Optometrist in McAlester, OK
• Providers in McAlester, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; 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.