Jodie Black (NPI# 1194227207, PAC ID# 0840541413) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1194227207 |
| PAC ID by PECOS | 0840541413 |
| Professional Enrollment ID | I20180920000903 |
| Full Name | Jodie Black |
| Organization Legal Name | KENNEDY MEDICAL GROUP PRACTICE, P.C. |
| Address |
205 E Laurel Rd Stratford NJ 08084-1301 |
| Phone Number | 8445422273 |
| Gender | F |
| Graduation Year | 2017 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 2860616877 |
| Number of Group Practice Members | 275 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 310086 | JEFFERSON STRATFORD HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 205 E Laurel Rd, Stratford, NJ 08084-1301 | 8445422273 | KENNEDY MEDICAL GROUP PRACTICE, P.C. |
| Organization Legal Name | KENNEDY MEDICAL GROUP PRACTICE, P.C. |
| Physicians | 263 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gloria L Jackson | Nurse Practitioner | Kennedy Medical Group Practice, P.C. | 435 Hurffville Cross Keys Rd, Turnersville, NJ 08012-2499 |
| Joseph Derose | Infectious Disease | Kennedy Medical Group Practice, P.C. | 151 Fries Mill Rd, Suite 100, Turnersville, NJ 08012-2016 |
| William Ross Green | Radiation Oncology | Kennedy Medical Group Practice, P.C. | 900 Medical Ctr Dr, Suite 201, Sewell, NJ 08080-2358 |
| Ashley Ferris | Obstetrics/gynecology | Kennedy Medical Group Practice, P.C. | 400 Medical Ctr Dr, Suite F, Sewell, NJ 08080-2362 |
| Nina Lane | Nurse Practitioner | Kennedy Medical Group Practice, P.C. | 18 E Laurel Rd, Stratford, NJ 08084-1327 |
| Deborah A Ubele | Family Medicine | Kennedy Medical Group Practice, P.C. | 1300 Liberty Pl, Sicklerville, NJ 08081-5710 |
| Rosemary A Decicco | Physician Assistant | Kennedy Medical Group Practice, P.C. | 457 Haddonfield Rd, Suite 110, Cherry Hill, NJ 08002-2223 |
| Duane R Monteith | Thoracic Surgery | Kennedy Medical Group Practice, P.C. | 333 Laurel Oak Rd, Voorhees, NJ 08043-4453 |
| Jennifer E Hummel | Obstetrics/gynecology | Kennedy Medical Group Practice, P.C. | 165 Princeton Ave, West Deptford, NJ 08096-3123 |
| Lisa C Dimedio | Internal Medicine | Kennedy Medical Group Practice, P.C. | 1 Regulus Dr A, Turnersville, NJ 08012-2427 |
| Street Address |
205 E LAUREL RD |
| City | STRATFORD |
| State | NJ |
| Zip | 08084-1301 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Natalia Eltabaa | Nurse Practitioner | Kennedy Medical Group Practice, P.C. | 205 E Laurel Rd, Stratford, NJ 08084-1301 |
| Kelly Linskey | Nurse Practitioner | Kennedy Medical Group Practice, P.C. | 205 E Laurel Rd, Stratford, NJ 08084-1301 |
| Christopher Huff | Clinical Social Worker | Kennedy Medical Group Practice, P.C. | 205 E Laurel Rd, Stratford, NJ 08084-1301 |
| Catherine N Bove | Nurse Practitioner | Kennedy Medical Group Practice, P.C. | 205 E Laurel Rd, Stratford, NJ 08084-1301 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Patricia C Obrien | Chiropractic | 321 Yale Ave, Suite A, Stratford, NJ 08084-1247 | |
| Robert J O'brien | Chiropractic | 321 Yale Ave, Suite A, Stratford, NJ 08084-1247 | |
| Elizabeth F Lipshutz | Clinical Social Worker | 11 E Laurel Rd, Suite B, Stratford, NJ 08084-1322 | |
| Andrew Levitas | Psychiatry | Rowansom Mental Health Center for Intellectual Disabilities | 109 E Laurel Rd, Stratford, NJ 08084-1324 |
| Sharon D Warner | Internal Medicine | Goldis Geriatrics P.C. | 119 E Laurel Rd, Stratford, NJ 08084-1324 |
| Robert L Salth | Optometry | 123 E Laurel Rd, Stratford, NJ 08084-1324 | |
| Natalie Tsigonis | General Practice | Goldis Geriatrics P.C. | 119 E Laurel Rd, Stratford, NJ 08084-1324 |
| Michael E Goldis | Geriatric Medicine | Goldis Geriatrics P.C. | 119 E Laurel Rd, Stratford, NJ 08084-1324 |
| S Mark Sacher | Psychiatry | Rowansom Mental Health Center for Intellectual Disabilities | 109 E Laurel Rd, Stratford, NJ 08084-1324 |
| Nina Lane | Nurse Practitioner | Kennedy Medical Group Practice, P.C. | 18 E Laurel Rd, Stratford, NJ 08084-1327 |
| Find all physicians in zip 08084 | |||
| City | STRATFORD |
| Zip Code | 08084 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | STRATFORD + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.