Affinity Healthcare Group Cherry Hill LLC

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

Legal business name

AFFINITY HEALTHCARE GROUP CHERRY HILL LLC

Practice address

1305 Kings Hwy N
Cherry Hill, NJ 08034-1919

Phone

(856) 651-7826

Fax

(856) 229-7142

NPI assigned

Aug 30, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Shauna Leigh Konnerth

Title

Compliance

Phone

(856) 651-7826

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ2 enrollments

Opioid treatment program

Medicare-enrolled since Sep 8, 2022

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth Brown, MD

  • Emergency Medicine Physician
  • Cherry Hill, NJ
  • NPI 1164521084

  NJ

  Medicare reassignment NPD
• Shelly Clavis, RN, MSN, NP-C, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Linden, NJ
  • NPI 1740524909

  NJ

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689897600000",
    "number": "1003583733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 KINGS HWY N",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341919",
            "telephone_number": "856-651-7826",
            "fax_number": "856-229-7142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 KINGS HWY N",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341919",
            "telephone_number": "856-651-7826",
            "fax_number": "856-229-7142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFINITY HEALTHCARE GROUP CHERRY HILL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-30",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A",
        "authorized_official_last_name": "KONNERTH",
        "authorized_official_first_name": "SHAUNA",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "COMPLIANCE",
        "authorized_official_telephone_number": "856-651-7826",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Afra Health New Jersey LLC
• Zahra Afsharzand, DMD
• Agd Nursing LLC
• Mary Ann Michele Ager, M.D.

• All providers in Cherry Hill, NJ
• Methadone Clinic in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.