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KENNEDY VISION HEALTH CENTER, LLC
NPI 1255165932
Optometrist in Otsego, MN

Active since August 27, 2024
9075 QUANTRELLE AVE NE STE 300, OTSEGO, MN 55330(763) 545-8850(763) 441-7631 Get Directions Write a Review

NPPES record last updated: August 27, 2024. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Kennedy Vision Health Center, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNEDY VISION HEALTH CENTER, LLC (NPI 1255165932) is a healthcare organization registered as an optometrist in Otsego, Minnesota and active in the NPI registry since August 2024. The organization lists Anthony Charles Traverse, Od/owner, as its authorized official.

NPPES Registry Identity

NPI1255165932
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameKENNEDY VISION HEALTH CENTER, LLC
Location Address9075 QUANTRELLE AVE NE STE 300Otsego, MN 55330-0139
Mailing Address10600 Old County Road 15Plymouth, MN 55441-6200 · (763) 373-6042 · Fax (763) 441-7631
Phone(763) 545-8850
Fax(763) 441-7631
Organization SubpartNo
Authorized OfficialAnthony Charles TraverseOd/owner · (763) 545-8850
Enumeration DateAugust 27, 2024
NPPES CertifiedAugust 27, 2024
✔ NPI 1255165932 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
9075 QUANTRELLE AVE NE STE 300, Otsego, MN 55330
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kennedy Vision Health Center, LLC's NPI number?

The NPI number for Kennedy Vision Health Center, LLC is 1255165932. It was assigned to this organization in the NPPES registry on August 27, 2024.

Where is Kennedy Vision Health Center, LLC located?

Kennedy Vision Health Center, LLC is located at 9075 Quantrelle Ave NE Ste 300, Otsego, MN 55330. The listed phone number is (763) 545-8850.

What is Kennedy Vision Health Center, LLC's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

When was this NPI record last updated?

The NPPES record for Kennedy Vision Health Center, LLC was last updated on August 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.