Individual provider Active NPI

Kathleen D Baumgardner, D. C.

  • Chiropractor
  • Marlton, NJ
National Provider Identifier
1033157474
Registry record updated Sep 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MC03392 Issued in NJ
Practice address
230 N Maple Ave
Suite G2
Marlton, NJ 08053-9415
Phone
(856) 983-5422
Fax
(856) 983-6579
NPI assigned
Jun 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X MC03392 NJ Primary

Addresses

Primary practice location

230 N Maple Ave
Suite G2
Marlton, NJ 08053-9415

Mailing address

230 N Maple Ave
Suite G2
Marlton, NJ 08053-9415
Phone (856) 983-5422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050404000259 NJ Practitioner - Chiropractic 1153378062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1986
Medicare assignment
May accept Medicare assignment
Group practices
Health Goals Chiropractic Center, Inc.Group PAC ID 0749377091, 6 clinicians

Practice addresses (Care Compare)

722 S White Horse Pike
Suite a
Somerdale, NJ 08083-1247
Phone (856) 784-5700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC03392NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Health Goals Chiropractic Center, Inc. Chiropractor CurrentSince Jul 3, 1991 Accepting new patients

Locations

230 N Maple Ave
Ste G2
Marlton, NJ 08053
Phone (856) 983-5422

722 S White Horse Pike
#A
Somerdale, NJ 08083
Phone (856) 784-5700

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1033157474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N MAPLE AVE",
            "address_2": "SUITE G2",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080539415",
            "telephone_number": "856-983-5422",
            "fax_number": "856-983-6579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N MAPLE AVE",
            "address_2": "SUITE G2",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080539415",
            "telephone_number": "856-983-5422",
            "fax_number": "856-983-6579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMGARDNER",
        "first_name": "KATHLEEN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D. C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC03392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; 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.