KENNEDY MEDICAL GROUP PRACTICE P.C. (NPI# 1881138154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881138154 |
| Entity Type | Organization |
| Organization Name | KENNEDY MEDICAL GROUP PRACTICE P.C. |
| Other Organization Name | KENNEDY HEALTH ALLIANCE |
| Practice Address |
630 B South White Horse Pike Hammonton NJ 08037 |
| Mailing Address |
205 E Laurel Rd Stratford NJ 08084-1301 |
| Practice Telephone | 8445422273 |
| Mailing Telephone | 8563447360 |
| Mailing Fax Number | 8563442315 |
| Enumeration Date | 2016-12-06 |
| Last Update Date | 2016-12-06 |
| Authorized Official Name | CARMAN CIERVO (CHIEF PHYSICIAN EXECUTIVE) |
| Authorized Official Telephone | 8563447360 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0411248 | 05 |
| Other Name | Type Code |
|---|---|
| Kennedy Health Alliance | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225559495 | Kennedy Medical Group Practice P.C. | Dietitian, Registered | 2211 Chapel Avenue West, Suite 301, Cherry Hill, NJ 08002 | 2017-06-28 |
| 1881987337 | Kennedy Medical Group Practice P.C. | Internal Medicine | 1 A Regulus Drive, Turnersville, NJ 08012 | 2011-05-17 |
| 1568996098 | Kennedy Medical Group Practice P.C. | Internal Medicine | 151 Fries Mill Rd, Suite 301, Turnersville, NJ 08012-2016 | 2017-04-11 |
| 1497295109 | Kennedy Medical Group Practice P.C. | Psychologist | 900 Route 168, Suite C#3, Blackwood, NJ 08012-3233 | 2017-02-28 |
| 1598203267 | Kennedy Medical Group Practice P.C. | Internal Medicine | 151 Fries Mill Rd, Suite 100, Turnersville, NJ 08012-2016 | 2017-02-02 |
| 1871039180 | Kennedy Medical Group Practice P.C. | Family Medicine | 100 Black Horse Pike, Audubon, NJ 08106-1950 | 2017-01-10 |
| 1942746367 | Kennedy Medical Group Practice P.C. | Family Medicine | 159 S Broad St, Woodbury, NJ 08096-2410 | 2017-01-09 |
| 1437693421 | Kennedy Medical Group Practice P.C. | Psychiatry & Neurology | 1305 Kings Hwy N, N#4, Cherry Hill, NJ 08034-1919 | 2016-12-09 |
| 1023374766 | Kennedy Medical Group Practice P.C. | Internal Medicine | 1300 Liberty Pl, Sicklerville, NJ 08081-5710 | 2012-04-06 |
| 1952615981 | Kennedy Medical Group Practice P.C. | Family Medicine | 165 Princeton Ave, West Deptford, West Deptford, NJ 08096-3123 | 2010-08-02 |
| Street Address |
630 B SOUTH WHITE HORSE PIKE |
| City | HAMMONTON |
| State | NJ |
| Zip Code | 08037 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497312532 | Hope On Wheels LLC | Transportation Broker | 882 12th Street, 882 12th Street D5, Hammonton, NJ 08037 | 2019-05-23 |
| 1679050389 | Lori's Wellness Loft | Massage Therapist | 240 S White House Pike, Suite B4, Hammonton, NJ 08037 | 2018-07-25 |
| 1306364773 | Elwyn New Jersey | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2404 4th Road, Folsom, NJ 08037 | 2017-09-06 |
| 1376070003 | Elwyn New Jersey | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1204 11th Street, Folsom, NJ 08037 | 2017-05-12 |
| 1467908350 | John Lloyd Jr. | Counselor | 63 Laurel Lane, Hammonton, NJ 08037 | 2016-08-30 |
| 1407218019 | Karon Ross | Counselor | 44 Fern Lane, Hammonton, NJ 08037 | 2016-03-23 |
| 1396106548 | Helen Durham | Counselor | 61 Laurel Lane, Hammonton, NJ 08037 | 2016-03-16 |
| 1972994481 | Person First New Jersey LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14 Heggan Ln, Heggan Ln, Hammonton, NJ 08037 | 2015-02-05 |
| 1659702298 | Alienta Limited Liability Company | Community/Behavioral Health | 425 N Third Street, Hammonton, NJ 08037 | 2013-12-09 |
| 1982940037 | Allies In Caring, Inc. | Community/Behavioral Health | 425 N. Third St., Hammonton, NJ 08037 | 2012-12-18 |
| Find all providers in zip 08037 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205190808 | Owen R Mcfarlane | Obstetrics & Gynecology | 860 S. White Horse Pike, Hammonton, NJ 08037 | 2012-06-27 |
| 1174586333 | Rodney Capiro | Obstetrics & Gynecology | 860 S White Horse Pike, Hammonton, NJ 08037-2018 | 2006-04-10 |
| 1922080340 | Mark A Demasi | Obstetrics & Gynecology | 653 S White Horse Pike, Hammonton, NJ 08037-2013 | 2005-11-20 |
| 1255523098 | Judith S Ruffin | Obstetrics & Gynecology | 860 S White Horse Pike, Hammonton, NJ 08037 | 2007-08-15 |
| 1306864202 | Kenneth M. Irvis | Obstetrics & Gynecology | 860 S White Horse Pike, Hammonton, NJ 08037-2018 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376172262 | Julia Buldo-licciardi | Obstetrics & Gynecology | 712 Beechcrest Dr, River Vale, NJ 07675-6053 | 2020-04-03 |
| 1154964773 | Gerard G Nahum | Obstetrics & Gynecology | 29 Canal Xing, Lake Hopatcong, NJ 07849-2419 | 2019-10-27 |
| 1558821587 | Todays Women Gynecology Pa | Obstetrics & Gynecology | 385 Prospect Ave Ste 314, Hackensack, NJ 07601-2570 | 2019-03-25 |
| 1679038962 | Nj Premier Women Health LLC | Obstetrics & Gynecology | 1300 Main Ave Ste 3c, Clifton, NJ 07011-2266 | 2019-01-31 |
| 1578041174 | St. Luke's Warren Physician Group, PC | Obstetrics & Gynecology | 39 Roseberry St Ste 2, Phillipsburg, NJ 08865-1627 | 2018-08-06 |
| 1881195881 | Fisayo Tunde | Obstetrics & Gynecology | 3322 Us Highway 22 Ste 1302, Branchburg, NJ 08876 | 2018-02-24 |
| 1477053072 | Vernon & Bustamante Assoc LLC | Obstetrics & Gynecology | 85 Nautilus Dr Ste A&b, Manahawkin, NJ 08050-2448 | 2018-02-20 |
| 1598264681 | Amy Patel | Obstetrics & Gynecology | 123 Franklin Corner Rd Ste 214, Lawrenceville, NJ 08648-2526 | 2018-02-05 |
| 1174033914 | Ragin Patel Md LLC | Obstetrics & Gynecology | 2177 Oak Tree Rd Ste 205, Edison, NJ 08820-1082 | 2017-10-06 |
| 1376067181 | Nghotra | Obstetrics & Gynecology | 3185 John F Kennedy Blvd, Jersey City, NJ 07306-3415 | 2017-08-02 |
| Find all providers with the same taxonomy | ||||
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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.