KENNEDY MEDICAL GROUP PRACTICE P.C. (NPI# 1952615981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952615981 |
| Entity Type | Organization |
| Organization Name | KENNEDY MEDICAL GROUP PRACTICE P.C. |
| Other Organization Name | KENNEDY HEALTH ALLIANCE |
| Practice Address |
165 Princeton Ave West Deptford West Deptford NJ 08096-3123 |
| Mailing Address |
205 E. Laurel Road Stratford NJ 08084 |
| Practice Telephone | 8563840210 |
| Practice Fax Number | 8563840218 |
| Mailing Telephone | 8567831987 |
| Mailing Fax Number | 8567831403 |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2014-07-10 |
| Authorized Official Name | KATHERINE SCHLEIDER (VP CLINICAL INTEGRATION) |
| Authorized Official Telephone | 8567831892 |
| Is Organization Subpart | Y |
| Parent Organization Name | KENNEDY UNIVERSITY HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 25MB08173000 | NJ | Allopathic & Osteopathic Physicians |
| 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 |
| 1881138154 | Kennedy Medical Group Practice P.C. | Family Medicine | 630 B South White Horse Pike, Hammonton, NJ 08037 | 2016-12-06 |
| 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 |
| Street Address |
165 PRINCETON AVE WEST DEPTFORD |
| City | WEST DEPTFORD |
| State | NJ |
| Zip Code | 08096-3123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659378321 | Irving Jay Klein | Family Medicine | 165 Princeton Ave, West Deptford, NJ 08096-3123 | 2005-07-07 |
| 1932564622 | Kennedy Medical Group Practice, PC | Internal Medicine | 165 Princeton Ave, West Deptford, NJ 08096-3123 | 2015-12-22 |
| 1700176864 | Christopher Michael Dick | Nurse Practitioner | 165 Princeton Ave, West Deptford, NJ 08096-3123 | 2011-04-11 |
| 1215173513 | Jacqueline Riedel | Family Medicine | 165 Princeton Ave, West Deptford, NJ 08096-3123 | 2008-12-17 |
| 1134327026 | Jennifer E. Hummel | Obstetrics & Gynecology | 165 Princeton Ave, West Deptford, NJ 08096-3123 | 2007-07-03 |
| 1790909760 | Michael E Monte Carlo | Family Medicine | 165 Princeton Ave, West Deptford, NJ 08096-3123 | 2007-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780226043 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1460 Cooper Street, Deptford, NJ 08096 | 2019-10-08 |
| 1730652058 | Robert Crawford Counseling & Consultation, LLC | Counselor | Robert Crawford Counseling & Consultation, LLC, 44 Cooper Street, Suite 208, Woodbury, NJ 08096 | 2019-01-09 |
| 1902381171 | Services To Overcome Drug Abuse Among Teenagers, Inc. | Clinic/Center | 124 N Broad Street, Woodbury, NJ 08096 | 2018-10-03 |
| 1225518715 | Michael West | Pharmacist | 631 West Mantua Ave, Woodbury, NJ 08096 | 2018-08-15 |
| 1053807891 | Standing Ground Counseling, LLC | Clinic/Center | 44 Cooper Street, Suite 104, Woodbury, NJ 08096 | 2018-07-05 |
| 1376054536 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 40 Hessian Avenue, Woodbury, NJ 08096 | 2017-10-16 |
| 1881105021 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1154 Bennett Drive, Deptford, NJ 08096 | 2017-10-16 |
| 1215448469 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7 North Evergreen Avenue, Woodbury, NJ 08096 | 2017-10-16 |
| 1801307137 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6 North Drexel Street, Woodbury, NJ 08096 | 2017-10-13 |
| 1295253847 | Sara Alven | Social Worker | 1 Lupton Avenue, Woodbury, NJ 08096 | 2017-09-05 |
| Find all providers in zip 08096 | ||||
| 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 |
|---|---|---|---|---|
| 1417045030 | John Joseph Gartland Jr. | Family Medicine | 636 B Kings Highway, West Deptford, NJ 08096 | 2006-10-10 |
| 1659378321 | Irving Jay Klein | Family Medicine | 165 Princeton Ave, West Deptford, NJ 08096-3123 | 2005-07-07 |
| 1447561121 | Tahseen Rabia Malik | Family Medicine | 831 Kings Hwy, Suite 100, West Deptford, NJ 08096-3162 | 2010-06-28 |
| 1215173513 | Jacqueline Riedel | Family Medicine | 165 Princeton Ave, West Deptford, NJ 08096-3123 | 2008-12-17 |
| 1790909760 | Michael E Monte Carlo | Family Medicine | 165 Princeton Ave, West Deptford, NJ 08096-3123 | 2007-04-12 |
| 1720139736 | Jay S Rosen | Family Medicine | 204 Grove Ave, Suite C, West Deptford, NJ 08086-2557 | 2007-01-16 |
| 1184684268 | Michael S Rogers | Family Medicine | 831 Kings Hwy, Suite 100, West Deptford, NJ 08096-3162 | 2006-03-24 |
| 1710946447 | Michael S Rogers Md Pa | Family Medicine | 831 Kings Hwy, Suite 100, West Deptford, NJ 08096-3162 | 2006-03-21 |
| 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 | WEST DEPTFORD |
| Zip Code | 08096 |
Please comment or provide details below to improve the information on KENNEDY MEDICAL GROUP PRACTICE P.C..
| 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.