KHS Ambulatory Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

24339 Issued in NJ

Legal business name

KHS AMBULATORY SURGERY CENTER, LLC

Practice address

405 Hurffville Cross Keys Rd
Suite 210
Sewell, NJ 08080

Phone

(856) 582-2072

Fax

(856) 582-8073

NPI assigned

Apr 13, 2009

Organization subpart

No

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

Authorized official

Name

Kristen Oconnor

Title

Authorized Official / Officer

Phone

(615) 376-7315

Specialties & licenses 1

Addresses

Other names 1

• Select Surgical Center at Kennedy Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Listed as

KHS Ambulatory Surgical CenterCCN 31C0001253

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Baylor University Medical Center

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1447250253

  Member Of

  NPD member
• VHS San Antonio Partners LLC

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rasesh Shah, M.D.

  • Otolaryngology Physician
  • Woodbury, NJ
  • NPI 1437159407
  NPD (past)

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731024000000",
    "number": "1124261771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 HURFFVILLE CROSSKEYS RD",
            "address_2": "STE 210",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080809344",
            "telephone_number": "856-582-2072",
            "fax_number": "856-582-8073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 HURFFVILLE CROSS KEYS RD",
            "address_2": "SUITE 210",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "08080",
            "telephone_number": "856-582-2072",
            "fax_number": "856-582-8073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHS AMBULATORY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-13",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A",
        "authorized_official_last_name": "OCONNOR",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL / OFFICER",
        "authorized_official_telephone_number": "615-376-7315"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NJ",
            "license": "24339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Select Surgical Center at Kennedy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Select Surgical Center at Kennedy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kennedy University Hospital, Inc
• Alexandra L Kenyon, MA
• Melissa Kerr, DPT
• Jacki Ketner, PT, DPT
• Malini M Khanna, M.D.
• Jeffrey A Kimelman, DMD
• Alexander King
• Alina King
• Christopher D. King
• Tina L King, RPH

• Ambulatory Surgical Clinic/Center in Sewell, NJ
• Providers in Sewell, NJ by specialty
• Ambulatory Surgical Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.