DR. KELLY M. LAVERDURE (NPI# 1568465656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568465656 |
| Entity Type | Individual |
| Full Name | DR. KELLY M. LAVERDURE |
| Other Name | KELLY M. KIERNAN |
| Credential | D.O. |
| Practice Address |
750 Brunswick Ave Trenton NJ 19178-8567 |
| Mailing Address |
P.o. Box 8500-8567 Philadelphia PA 19178-8567 |
| Practice Telephone | 6098157810 |
| Practice Fax Number | 6098157814 |
| Mailing Telephone | 6098157887 |
| Mailing Fax Number | 2158607754 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2012-08-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | OS013010 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1011991960001 | 05 |
| Street Address |
750 BRUNSWICK AVE |
| City | TRENTON |
| State | NJ |
| Zip Code | 19178-8567 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477153450 | Thomas Wieczenski | Registered Nurse | 750 Brunswick Ave, Trenton, NJ 08638-4143 | 2020-10-28 |
| 1487252979 | Ashley Yeh | Pharmacist | 750 Brunswick Ave, Trenton, NJ 08638-4143 | 2020-10-15 |
| 1821604380 | Steven Chen | Pharmacist | 750 Brunswick Ave, Trenton, NJ 08638-4143 | 2020-09-21 |
| 1669081063 | Reena R Concepcion | Pharmacist | 750 Brunswick Ave, Trenton, NJ 08638-4143 | 2020-07-31 |
| 1851915649 | Matthew M Rydlewski Jr. | Emergency Medicine | 750 Brunswick Ave, Trenton, NJ 08638-4143 | 2020-06-08 |
| 1518588243 | Sally Johnson | Registered Nurse | 750 Brunswick Ave, Trenton, NJ 08638-4143 | 2020-05-05 |
| 1356961882 | Maksym Palii | Student in an Organized Health Care Education/Training Program | 750 Brunswick Ave, Trenton, NJ 08638-4143 | 2020-04-24 |
| 1669092250 | Amy Theresa Pulikeyil | Student in an Organized Health Care Education/Training Program | 750 Brunswick Ave, Trenton, NJ 08638-4143 | 2020-04-23 |
| 1720607260 | Mayilathal Vasudevan | Registered Nurse | 750 Brunswick Ave, Trenton, NJ 08638-4143 | 2020-04-14 |
| 1770102766 | Ruth Graciela Ramon Tapia | Student in an Organized Health Care Education/Training Program | 750 Brunswick Ave, Trenton, NJ 08638-4143 | 2020-04-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639175359 | Benita Trotter | Nurse Anesthetist, Certified Registered | 2301 East Allegheny Avenue, Philadelphia, PA 19178-0001 | 2005-06-27 |
| 1598893893 | Aria Health Physician Services | Registered Nurse | 3998 Red Lion Rd, Nurse Practitioners - Er, Philadelphia, PA 19178-0001 | 2007-03-01 |
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881852887 | Rafeek M Farah Md PC | Family Medicine | 2105 West Rd, Trenton, MI 48183-3897 | 2008-05-27 |
| 1912177197 | The Moore Clinic, LLC | Family Medicine | 1709 S College St, Trenton, TN 38382-3908 | 2008-03-04 |
| 1255478269 | Augustine Sang Yoon Lee | Family Medicine | 905 Stuyvesant Avenue, Trenton, NJ 08618-4021 | 2007-01-31 |
| 1528129947 | John Louis Rorro | Family Medicine | 295 Hamilton Ave, Trenton, NJ 08609-2714 | 2006-12-12 |
| 1497851604 | Andrew Nguyen | Family Medicine | 308 N Main Street, Trenton, FL 32693 | 2006-09-15 |
| 1245274422 | Jennifer A. Bowe | Family Medicine | 3300 E 10th St, Trenton, MO 64683-9579 | 2006-06-16 |
| 1215974142 | Antonio Villarin Abary | Family Medicine | 445 White Horse Ave, Suite 202, Trenton, NJ 08610-1408 | 2006-05-31 |
| 1780649012 | Lucinda S Hill | Family Medicine | 13570 N Main St, Trenton, GA 30752-2012 | 2006-04-19 |
| 1912973900 | Arnel A Garcia | Family Medicine | 409 East Broadway, Trenton, IL 62293-1780 | 2006-02-28 |
| 1952373847 | Robert Patten | Family Medicine | 390 Bar Harbor Rd, Trenton, ME 04605-5807 | 2006-02-03 |
| Find all providers in TRENTON | ||||
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| 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.