KENNEDY MEDICAL GROUP PRACTICE, P.C. (NPI# 1932511987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932511987 |
| Entity Type | Organization |
| Organization Name | KENNEDY MEDICAL GROUP PRACTICE, P.C. |
| Other Organization Name | KENNEDY HEALTH ALLIANCE |
| Practice Address |
188 Fries Mill Rd Suite N3 Blackwood NJ 08012-2015 |
| Mailing Address |
205 E Laurel Rd 2nd Floor Stratford NJ 08084-1301 |
| Practice Telephone | 8568750505 |
| Practice Fax Number | 8568759556 |
| Mailing Telephone | 8567831987 |
| Mailing Fax Number | 8567831403 |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2015-07-01 |
| Authorized Official Name | KATHERINE SCHLEIDER (VPCLINICAL INTEGRATION & POPULATION) |
| Authorized Official Telephone | 8567831987 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 3911101 | 05 | |
| NJ | RAILROAD MEDICARE | P00633440 | 01 |
| Other Name | Type Code |
|---|---|
| Kennedy Health Alliance | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669847646 | Kennedy Medical Group Practice, P.C. | Internal Medicine | 2211 Chapel Ave West, Ste 301, Cherry Hill, NJ 08002 | 2015-12-02 |
| 1578975520 | Kennedy Medical Group Practice, P.C. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 485 Williamstown Road, Sicklerville, NJ 08081 | 2014-05-27 |
| 1629343421 | Kennedy Medical Group Practice, P.C. | Surgery | 543 Egg Harbor Road, Sewell, NJ 08080-2335 | 2012-03-13 |
| 1558727677 | Kennedy Medical Group Practice, P.C. | Surgery | 333 Laurel Oak Rd, Voorhees, NJ 08043-4453 | 2016-01-05 |
| 1346615333 | Kennedy Medical Group Practice, P.C. | Internal Medicine | 457 Haddonfield Rd, Ste. 110, Cherry Hill, NJ 08002-2220 | 2015-12-02 |
| 1902271992 | Kennedy Medical Group Practice, P.C. | Surgery | 668 Main St, Ste. 4, Lumberton, NJ 08048-5016 | 2015-12-02 |
| 1003281080 | Kennedy Medical Group Practice, P.C. | Surgery | 570 Egg Harbor Rd, Suite C-2, Sewell, NJ 08080-2359 | 2015-12-02 |
| 1164834297 | Kennedy Medical Group Practice, P.C. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2301 Evesham Road, Suite 406, Voorhees, NJ 08043 | 2014-05-23 |
| 1255743357 | Kennedy Medical Group Practice, P.C. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 524 Williamstown Road, Sicklerville, NJ 08081 | 2014-05-22 |
| 1952726796 | Kennedy Medical Group Practice, P.C. | Hospitalist | 333 Laurel Oak Rd, Voorhees, NJ 08043-4453 | 2014-03-04 |
| Street Address |
188 FRIES MILL RD SUITE N3 |
| City | BLACKWOOD |
| State | NJ |
| Zip Code | 08012-2015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740898550 | Caroline I Scott | In Home Supportive Care | 60 Lawrence Ln, Blackwood, NJ 08012 | 2020-07-17 |
| 1073154092 | Gina Marie Romano | Behavioral Analyst | 12 Braemar Ave, Blackwood, NJ 08012 | 2019-10-01 |
| 1245745777 | Chandler Group Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3408 Hight Street, Blackwood, NJ 08012 | 2017-12-06 |
| 1962917625 | Dpsp Health Care LLC | Home Health | 860 Rt. 168, Suite 207, Turners Ville, NJ 08012 | 2017-12-04 |
| 1871003103 | Sayana Modi LLC | Pharmacy | 460 Hurffville Crosskeys Rd, Tunersville, NJ 08012 | 2017-09-30 |
| 1427590827 | Cillo Chiropractic LLC | Chiropractor | 10 Woodlane Drive, Blackwood, NJ 08012 | 2016-11-16 |
| 1609327006 | Lena F Robinson | Registered Nurse | 435 Huffville Crosskeys Road, Turnersville, NJ 08012 | 2016-10-20 |
| 1316493026 | Partners In Homecare Services | In Home Supportive Care | 400 East Church St ., Blackwood, NJ 08012 | 2016-09-01 |
| 1710357710 | Wendy Hughes | Counselor | 900 Route 168 Ste B6, Turnersville, NJ 08012 | 2015-10-02 |
| 1043602337 | Erika White | Pharmacy Technician | 4001 State Route 42, Turnersville, NJ 08012 | 2015-02-24 |
| Find all providers in zip 08012 | ||||
| Taxonomy Code | 207VX0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Obstetrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063916716 | Women Physician LLC | Obstetrics & Gynecology | 840 Bergen Ave, Jersey City, NJ 07306-4507 | 2018-03-19 |
| 1922426485 | Kristina Williams | Obstetrics & Gynecology | 6100 Main Street Complex, 901 Centennial Blvd, Voorhees, NJ 08043-0000 | 2014-04-02 |
| 1811311392 | Manfred David Epstein | Obstetrics & Gynecology | 64 Jane Ct, Westbury, NJ 11590 | 2014-02-05 |
| 1639486756 | Edio John Zampaglione | Obstetrics & Gynecology | 33 Kanouse Ln, Montville, NJ 07045-9535 | 2010-09-10 |
| 1083898035 | Joseph A. Raimondi | Obstetrics & Gynecology | 1312 Todd Rd, Toms River, NJ 08755-2126 | 2007-12-27 |
| 1245424860 | Underwood Prenatal Care Program | Obstetrics & Gynecology | 543 N Broad St, Woodbury, NJ 08096-1603 | 2007-08-28 |
| 1841409075 | Kasthuri Pothiraj | Obstetrics & Gynecology | 6 Goldenpond Dr, Milltown, NJ 08850-2181 | 2007-05-22 |
| 1174746846 | Dana B. Jacoby, Md, LLC | Obstetrics & Gynecology | 766 Shrewsbury Avenue, 4th Floor, Tinton Falls, NJ 07724 | 2007-04-11 |
| 1972687473 | Regina T Sullivan | Obstetrics & Gynecology | 985 Belvidere Rd, Phillipsburg, NJ 08865-1778 | 2006-10-24 |
| 1811099351 | Peter Louis Delotto II | Obstetrics & Gynecology | 4 Jonathan Smith Rd, Morristown, NJ 07960-3409 | 2006-09-04 |
| 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.