Individual provider Active NPI

Kristi A. Kennedy, WHNP-BC

  • Adult Health Nurse Practitioner
  • Voorhees, NJ
National Provider Identifier
1003802729
Registry record updated Apr 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NR15415200 Issued in NJ
Practice address
900 Centennial Blvd Ste M
Voorhees, NJ 08043
Phone
(855) 632-2667
NPI assigned
Sep 27, 2005
Last updated
Apr 3, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 415907-1 NY
Women's Health Nurse Practitioner 363LW0102X 415907-1 NY
Adult Health Nurse Practitioner 363LA2200X 26NR15415200 NJ Primary

Addresses

Primary practice location

900 Centennial Blvd Ste M
Voorhees, NJ 08043

Mailing address

1 Federal St # 200
Camden, NJ 08103-1088
Phone (856) 356-4924

Other practice location 1

3458 Neely Road
McGuire AFB, NJ 08641-0000
Phone (609) 754-9373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221031001414 NY Practitioner - Nurse Practitioner 4981821212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Heroes Way
Riverhead, NY 11901-2054
Phone (631) 414-6871

27005 75TH Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-4449

301 E Main St
Bay Shore, NY 11706-8408
Phone (516) 734-8656

450 Lakeville Rd
New Hyde Park, NY 11042-1118
Phone (516) 734-8900

896 Old Country Rd
Riverhead, NY 11901-2154
Phone (631) 846-5200

9525 Queens Boluevard
2ND Floor Suite B
Rego Park, NY 11374-4511
Phone (718) 925-6200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.07 of 100Reported as group
Quality
57.91
Promoting interoperability
77
Improvement activities
40
Cost
80.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
415907-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Health System Medical Faculty Group Practice Inc CurrentSince Jul 5, 2022 Accepting new patients

Locations

450 Lakeville Rd
North New Hyde Park, NY 11042
Phone (516) 321-3000

27005 76th Ave
North New Hyde Pk, NY 11040

9525 Queens Blvd
Ste B
Rego Park, NY 11374
Phone (718) 925-6200

1 Heroes Way
Riverhead, NY 11901
Phone (631) 548-6000

896 Old Country Rd
Riverhead, NY 11901
Phone (631) 727-5469

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: kkennedy61108@northwell.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1003802729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CENTENNIAL BLVD STE M",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "08043",
            "telephone_number": "855-632-2667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3458 Neely Road",
            "address_purpose": "LOCATION",
            "city": "McGuire AFB",
            "state": "NJ",
            "postal_code": "086410000",
            "country_code": "US",
            "telephone_number": "609-754-9373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KRISTI",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-27",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "415907-1",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "415907-1",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NR15415200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.