BRUCE ERIC KENNEDY (NPI# 1225681794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1225681794 |
Entity Type | Individual |
Full Name | BRUCE ERIC KENNEDY |
Credential | LDO |
Practice Address |
351 Alabama Rd Adel GA 31620-3818 |
Practice Telephone | 2298969994 |
Practice Fax Number | 2298969996 |
Mailing Telephone | 2298969994 |
Mailing Fax Number | 2298969996 |
Enumeration Date | 2019-07-23 |
Last Update Date | 2019-07-23 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
LDO2544 | GA | Eye and Vision Services Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386627461 | Bruce David Kennedy | Anesthesiology | 45 N.e. Loop 410 #900, San Antonio, TX 78216 | 2005-11-22 |
1659758159 | Bruce Kennedy | Pediatrics | 100 Medical Park Dr, Ste 110, Concord, NC 28025-2948 | 2015-05-04 |
1770635658 | Bruce Edward Kennedy | Dentist | 435 Pine St, Rochester, MI 48307-1933 | 2007-01-18 |
1871517078 | Bruce Orval Kennedy | Dentist | 1117 Main Ave, Crete, NE 68333-2259 | 2006-07-27 |
1912922022 | Bruce Allen Kennedy | Dentist | 3601 S 6th Ave, Tucson, AZ 85723-0001 | 2006-07-12 |
1093742157 | Bruce E Kennedy | Nurse Anesthetist, Certified Registered | 415 W Gray St, Norman, OK 73069-7117 | 2006-06-26 |
Street Address |
351 ALABAMA RD |
City | ADEL |
State | GA |
Zip Code | 31620-3818 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386003689 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 351 Alabama Rd, Adel, GA 31620-3818 | 2016-02-15 |
1033719711 | Sala Pressley | Pharmacist | 351 Alabama Rd, Adel, GA 31620-3818 | 2020-10-30 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588024970 | Wal-mart Store East, Lp | Technician/Technologist | 351 Alabama Road, Adel, GA 31620 | 2016-02-29 |
1144699141 | Alexander Warren | Nurse Practitioner | 110 S Hutchinson Ave, Adel, GA 31620 | 2015-09-20 |
1538474002 | Tift Regional Health System, Inc. | Specialist | 103 East James Street, Adel, GA 31620 | 2010-08-09 |
1427388578 | Newhaven | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 615 South Hutchinson Avenue, Adel, GA 31620 | 2010-01-12 |
1942374350 | South Georgia Csb | Clinic/Center | 203 Industrial Park Drive, Adel, GA 31620 | 2006-11-17 |
1457424616 | Cook County Board of Education | Local Education Agency (LEA) | 1109 N Parrish Ave, Adel, GA 31620 | 2006-11-16 |
1366513210 | Thomas D Fausett Jr. | Family Medicine | 707 N Parrish Ave, Adel, GA 31620 | 2006-11-13 |
1689765851 | Chris T. Hilliard | Dentist | 130 S. Parrish Ave., Adel, GA 31620 | 2006-09-27 |
1245247303 | Mark A Clegg | Dentist | 606 N Hutchinson Ave, Adel, GA 31620 | 2006-08-02 |
1336102938 | Dca of Adel LLC | Clinic/Center | 701 North Hutchinson Avenue, Adel, GA 31620 | 2006-04-07 |
Find all providers in zip 31620 |
Taxonomy Code | 156FX1800X |
Grouping | Eye and Vision Services Providers |
Classification | Technician/Technologist |
Specialization | Optician |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588024970 | Wal-mart Store East, Lp | Technician/Technologist | 351 Alabama Road, Adel, GA 31620 | 2016-02-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427667302 | Carole F Medou | Technician/Technologist | 57 Hurricane Shoals Rd Nw Ste A, Lawrenceville, GA 30046-5396 | 2020-07-28 |
1255966206 | Steven W Burton | Technician/Technologist | 2498 Wingfield Dr, Austell, GA 30106-1762 | 2020-03-10 |
1477185205 | Dale A Klauss | Technician/Technologist | 294 Kenwood Rd Ste A, Fayetteville, GA 30214-3451 | 2020-02-10 |
1104380682 | National Vision Inc | Technician/Technologist | 97 Parkway Dr, Fort Oglethorpe, GA 30742-4249 | 2019-01-29 |
1134683600 | National Vision Inc | Technician/Technologist | 3159 Highway 278 Ne, Covington, GA 30014-2301 | 2019-01-29 |
1255818993 | Kerryn Castellon | Technician/Technologist | 55 Sudderth St, Buford, GA 30518-3335 | 2018-07-25 |
1770075731 | National Vision, Inc. | Technician/Technologist | 916 Loganville Hwy Ste 300, Bethlehem, GA 30620-2145 | 2018-06-05 |
1598262487 | National Vision, Inc. | Technician/Technologist | 534 Marketplace Pkwy Ste 740, Dawsonville, GA 30534-7549 | 2018-04-09 |
1720582992 | Amos D Washington | Technician/Technologist | 10269 Industrial Blvd Ne, Covington, GA 30014-1485 | 2018-03-21 |
1619490489 | Lisa Stonebraker | Technician/Technologist | 105 E Main St Ste 116, Woodstock, GA 30188-5013 | 2017-07-24 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on BRUCE ERIC KENNEDY.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.