Kennedy Medical Group

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

25MB04815900 Issued in NJ

Legal business name

KENNEDY MEDICAL GROUP

Practice address

73 N Maple Ave
Marlton, NJ 08053-1782

Phone

(856) 596-0558

Fax

(856) 596-4043

NPI assigned

Jan 25, 2012

Organization subpart

Yes

Parent organization

KENNEDY MEMORIAL HOSPITAL UNIVERSITY MEDICAL CENTER INC.As reported in NPPES

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

Authorized official

Name

Kathy Schleider

Title

Director, Physician Integration

Phone

(856) 783-1892

Specialties & licenses 1

Addresses

Other names 1

• Kennedy Health Alliance Doing business as

Part of

Kennedy Neph Hyper Asso

Locations

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376870400000",
    "number": "1083985857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 N MAPLE AVE",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531782",
            "telephone_number": "856-596-0558",
            "fax_number": "856-596-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 N MAPLE AVE",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531782",
            "telephone_number": "856-596-0558",
            "fax_number": "856-596-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KENNEDY MEMORIAL HOSPITAL UNIVERSITY MEDICAL CENTER INC.",
        "enumeration_date": "2012-01-25",
        "last_updated": "2013-08-19",
        "status": "A",
        "authorized_official_last_name": "SCHLEIDER",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "DIRECTOR, PHYSICIAN INTEGRATION",
        "authorized_official_telephone_number": "856-783-1892"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MB04815900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kennedy Health Alliance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Kelley, LCSW
• Cynthia Carr Kelly, M.A., L.P.C.
• Rebecca L Kelly, APN
• Tina Kelly, MS, OTR/L
• William James Kelly, FNP-C
• Kennedy Medical Group Practice, P.C.
• Megan Kennedy, FNP-BC
• Barbara E Kenney, CRNA
• Thomas Kerrigan, MD
• Kessler Institute for Rehabilitation, Inc.

• Neurology Physician in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Neurology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.