Individual provider Active NPI

Nicholas H Lord, PA-C

  • Physician Assistant
  • Cherry Hill, NJ
National Provider Identifier
1013510767
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00611400 Issued in NJ
Practice address
2201 Chapel Ave W
Cherry Hill, NJ 08002-2048
Phone
(856) 488-6500
NPI assigned
Nov 17, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00611400 NJ Primary

Addresses

Primary practice location

2201 Chapel Ave W
Cherry Hill, NJ 08002-2048

Mailing address

209 Dickinson St
Philadelphia, PA 19147-6003
Phone (570) 573-4869

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210419001793 PA Practitioner - Physician Assistant 7719395425 Reassigns benefits to 2 organizations
I20220831001898 NJ Practitioner - Physician Assistant 7719395425 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kennedy Medical Group Practice, P.C.Group PAC ID 2860616877, 417 clinicians

Practice addresses (Care Compare)

18 E Laurel Rd
Stratford, NJ 08084-1327
Phone (856) 513-4124

2201 Chapel Ave W
Cherry Hill, NJ 08002-2048
Phone (856) 513-4124

2211 Chapel Ave W
301 Kha General Surgery
Cherry Hill, NJ 08002-2048
Phone (856) 665-2017

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (856) 513-4124

457 Haddonfield Rd
Suite 110
Cherry Hill, NJ 08002-2223
Phone (844) 542-2273

Hospital & facility affiliations

  • Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Physician Group, Inc. CurrentSince May 24, 2021 Accepting new patients
Kennedy Medical Group Practice PC CurrentSince Sep 23, 2024 Accepting new patients
Kennedy Medical Group Practice, P.C. CurrentSince Sep 23, 2024 Accepting new patients
St Luke'S Physician Group Inc CurrentSince May 24, 2021 Accepting new patients
Kennedy Medical Group Practice P.C. Past Accepting new patients
Mordecai & Caravello Wellness, LLC Past Accepting new patients

Locations

2201 Chapel Ave W
Cherry Hill, NJ 08002
Phone (856) 488-6500

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

100 Paramount Blvd
Orwigsburg, PA 17961
Phone (272) 639-1000

Organizations & group practices 10

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

Hospital & facility affiliations 1

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": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1013510767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 DICKINSON ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191476003",
            "telephone_number": "570-573-4869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 CHAPEL AVE W",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080022048",
            "telephone_number": "856-488-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORD",
        "first_name": "NICHOLAS",
        "middle_name": "H",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-17",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00611400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.