Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Christina Tan Michelle Kennedy, OD

Individual provider Optometrist · NPI 1154480911

Christina Tan Michelle Kennedy, OD is an Optometry in Fort Wayne, Indiana. Qualified in 2005, 21 years ago. Practices with C J Pataluch OD PC, a 4-clinician group. Licensed in Georgia, Indiana, Michigan and Tennessee.

Years since qualifying
21
Licensed in
GA, IN, MI, TN
In the registry since
2006
Specialties on file
4
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

6709 W Jefferson Blvd
Fort Wayne, IN 46804-6209
Phone: (260) 432-8409
Fax: (260) 484-0616
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 18003936AB (IN)
Optometrist Taxonomy 152W00000X · Licence OPT002409 (GA)
Optometrist Taxonomy 152W00000X · Licence 4901004315 (MI)
Optometrist Taxonomy 152W00000X · Licence 2916 (TN)

Record details

NPI number1154480911
Entity typeIndividual (Type 1)
GenderFemale
Credentials OD
Sole proprietorYes
NPI enumeratedDecember 7, 2006
Last updated in NPPESMay 3, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice C J Pataluch Od Pc — 4 clinicians
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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