KENNEDY MEDICAL GROUP PRACTICE, P.C. D/B/A KENNEDY HEALTH ALLIANCE (NPI# 1902217607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902217607 |
| Entity Type | Organization |
| Organization Name | KENNEDY MEDICAL GROUP PRACTICE, P.C. D/B/A KENNEDY HEALTH ALLIANCE |
| Practice Address |
1300 Liberty Pl Sicklerville NJ 08081-5710 |
| Practice Telephone | 8562628100 |
| Mailing Telephone | 8562628100 |
| Mailing Fax Number | 8568856859 |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2014-08-18 |
| Authorized Official Name | AMANDA MARIE FOX (NP) |
| Authorized Official Telephone | 8562628100 |
| Authorized Official Credential | FNP-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 26NJ00504300 | NJ | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174663470 | Kennedy Medical Group Practice, P.C. D/b/a Kennedy Health Alliance | Internal Medicine | 25 E Laurel Rd, Stratford, NJ 08084-1322 | 2007-02-07 |
| 1952786337 | Kennedy Medical Group Practice, P.C. D/b/a Kennedy Health Alliance | Internal Medicine | 333 Laurel Oak Rd, Voorhees, NJ 08043-4453 | 2015-07-27 |
| 1235517707 | Kennedy Medical Group Practice, P.C. D/b/a Kennedy Health Alliance | Family Medicine | 205 E Laurel Rd, 2nd Floor, Stratford, NJ 08084-1301 | 2015-05-15 |
| 1619365152 | Kennedy Medical Group Practice, P.C. D/b/a Kennedy Health Alliance | Internal Medicine | 205 E Laurel Rd, Stratford, NJ 08084-1301 | 2015-01-07 |
| Street Address |
1300 LIBERTY PL |
| City | SICKLERVILLE |
| State | NJ |
| Zip Code | 08081-5710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669485751 | Julius Mingroni | Family Medicine | 1300 Liberty Pl, Sicklerville, NJ 08081-5710 | 2006-08-13 |
| 1316302003 | Kennedy Medical Group Practice, PC | Surgery | 1300 Liberty Pl, Sicklerville, NJ 08081-5710 | 2015-12-22 |
| 1205244910 | Kennedy University Hospital, Inc | Clinic/Center | 1300 Liberty Pl, Lakeside Business Center, Sicklerville, NJ 08081-5710 | 2014-07-25 |
| 1023374766 | Kennedy Medical Group Practice P.C. | Internal Medicine | 1300 Liberty Pl, Sicklerville, NJ 08081-5710 | 2012-04-06 |
| 1346486032 | Lakeside Internal Medicine Associates,llc | Internal Medicine | 1300 Liberty Pl, Sicklerville, NJ 08081-5710 | 2008-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771031 | Clack Associates, LLC. | Counselor | 603 Liberty Place, Sicklerville, NJ 08081 | 2019-10-13 |
| 1164901351 | Devereux Foundation | Day Training, Developmentally Disabled Services | 1601 - 1603 Sicklerville Road, Sicklerville, NJ 08081 | 2018-08-09 |
| 1467930990 | Brooke Schatzman | Lactation Consultant, Non-RN | 112 Hampton Court, Sicklerville, NJ 08081 | 2018-08-06 |
| 1831686443 | Grandular Senior Living | Day Training/Habilitation Specialist | 542 Berlin Cross Key Road Ste 3-270, Sicklerville, NJ 08081 | 2018-04-18 |
| 1942718465 | Community Dental of Sicklerville, P.C. | Dentist | 513 Cross Keys Road, Sicklerville, NJ 08081 | 2018-01-18 |
| 1831609304 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10 Brandon Court, Sicklerville, NJ 08081 | 2017-10-10 |
| 1710402631 | Premiere Behavioral Supports | Behavior Technician | 404 Independence Blvd, Sicklerville, NJ 08081 | 2017-08-11 |
| 1285167346 | A Better Concept | Community/Behavioral Health | 20 Wildcat Branch Dr, Sicklerville, NJ 08081 | 2017-04-06 |
| 1558712299 | Shaquira Briggs | Counselor | 40 Vernon Court, Sicklerville, NJ 08081 | 2016-06-23 |
| 1588012496 | Grace Musokae | Pharmacist | 412 Sicklerville Rd, Jolin's Pharmacy #103, Sicklerville, NJ 08081 | 2016-06-01 |
| Find all providers in zip 08081 | ||||
| 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 |
|---|---|---|---|---|
| 1891028916 | Jaigopal Balkrishna Benegal | Family Medicine | 10 Asberry Pl, Sicklerville, NJ 08081-1720 | 2009-09-08 |
| 1669485751 | Julius Mingroni | Family Medicine | 1300 Liberty Pl, Sicklerville, NJ 08081-5710 | 2006-08-13 |
| 1104860154 | Josette C Palmer | Family Medicine | 416 Sicklerville Rd, Suite A1, Sicklerville, NJ 08081-2556 | 2006-06-16 |
| 1013390426 | Patient First Maryland Physicians Group, P.C. | Family Medicine | 606 Cross Keys Rd, Sicklerville, NJ 08081-9513 | 2015-07-02 |
| 1235231044 | Harry Walton Sharp Jr. | Family Medicine | 524 Williamstown Rd Ste A, Sicklerville, NJ 08081-1800 | 2006-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285234609 | Universal Management Group Inc. | Family Medicine | 611 Albert Pl, Ridgewood, NJ 07450-5308 | 2020-10-26 |
| 1962009381 | Savannah Haririe | Family Medicine | 9 N Dorado Dr, Morristown, NJ 07960 | 2020-10-08 |
| 1023615168 | Well Health Medical Practice | Family Medicine | 676 Amboy Ave Ste 4, Woodbridge, NJ 07095-3144 | 2020-10-01 |
| 1538776380 | Reusik | Family Medicine | 302 Brookmead Dr, Cherry Hill, NJ 08034-2729 | 2020-09-25 |
| 1265048359 | Seungyeon Lee | Family Medicine | 4609 Quail Ridge Dr, Plainsboro, NJ 08536-4232 | 2020-09-23 |
| 1558976670 | Nyc Regenerative Medicine Inc. | Family Medicine | 315 Route 34 Ste 103, Colts Neck, NJ 07722-2444 | 2020-09-15 |
| 1831700715 | Tree of Life Integrative Family Medicine | Family Medicine | 1200 Little Gloucester Rd Apt 1315, Clementon, NJ 08021-5874 | 2020-08-13 |
| 1972127629 | Alysha Marengo | Family Medicine | 326 Pine St, Pompton Lakes, NJ 07442-1617 | 2020-05-28 |
| 1790308583 | Iz Medical LLC | Family Medicine | 250 Moonachie Rd, Moonachie, NJ 07074-1378 | 2020-05-27 |
| 1629691241 | Wayne R Schneider,m.d.,llc | Family Medicine | 56 Tuckahoe Rd, Marmora, NJ 08223-1206 | 2020-05-19 |
| Find all providers with the same taxonomy | ||||
| City | SICKLERVILLE |
| Zip Code | 08081 |
Please comment or provide details below to improve the information on KENNEDY MEDICAL GROUP PRACTICE, P.C. D/B/A KENNEDY HEALTH ALLIANCE.
| 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.