Individual provider Active NPI

Jacqueline F Byrd, APN

  • Adult Health Nurse Practitioner
  • Magnolia, NJ
National Provider Identifier
1104295492
Registry record updated Sep 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00544900 Issued in NJ
Practice address
501 Pasadena Dr
Magnolia, NJ 08049-1631
Phone
(856) 309-1158
NPI assigned
Sep 17, 2015
Last updated
Sep 17, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00544900 NJ Primary

Addresses

Primary practice location

501 Pasadena Dr
Magnolia, NJ 08049-1631

Mailing address

501 Pasadena Dr
Magnolia, NJ 08049-1631
Phone (856) 309-1158

Other names 1

  • Miss Jacqueline Figueroa Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20180712001774 NJ Practitioner - Nurse Practitioner 1658627252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00544900NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Medical Group P.C. CurrentSince Jul 1, 2018 Accepting new patients
Kennedy Medical Group Practice, P.C. CurrentSince Jun 15, 2021 Accepting new patients
Kennedy Medical Group Practice PC CurrentSince Jul 1, 2018 Accepting new patients
Kennedy Medical Group Practice P.C. Past Accepting new patients

Locations

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

400 Laurel Oak Rd
Ste 105
Voorhees, NJ 08043
Phone (609) 304-0991

Organizations & group practices 4

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 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": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1104295492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 PASADENA DR",
            "city": "MAGNOLIA",
            "state": "NJ",
            "postal_code": "080491631",
            "telephone_number": "856-309-1158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 PASADENA DR",
            "city": "MAGNOLIA",
            "state": "NJ",
            "postal_code": "080491631",
            "telephone_number": "856-309-1158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRD",
        "first_name": "JACQUELINE",
        "middle_name": "F",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-17",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00544900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "FIGUEROA",
            "prefix": "MISS",
            "credential": "APN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Magnolia, NJ

Sources for this page

Verify at the official NPI Registry.