Individual provider Active NPI

Jessica Hayes

  • Advanced Practice Midwife
  • Clifton, NJ
National Provider Identifier
1164960480
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
25ME00060401 Issued in NJ
Practice address
716 Broad St
Clifton, NJ 07013-1645
Phone
(201) 567-0810
NPI assigned
Feb 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 25ME00060401 NJ Primary

Addresses

Primary practice location

716 Broad St
Clifton, NJ 07013-1645

Mailing address

716 Broad St
Clifton, NJ 07013-1645

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210720003938 NJ Practitioner - Certified Nurse Midwife (CNM) 0749683399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

165 Princeton Ave
West Deptford, NJ 08096-3123
Phone (844) 542-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
25ME00060401NJMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Medical Group Practice, P.C. CurrentSince Aug 1, 2021 Accepting new patients
Kennedy Medical Group Practice, P.C. Current Accepting new patients
Kennedy Medical Group Practice PC CurrentSince Aug 1, 2021 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

165 Princeton Ave
West Deptford, NJ 08096
Phone (856) 384-0210

Organizations & group practices 3

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": "1486425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1164960480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 BROAD ST",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 BROAD ST",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131645",
            "telephone_number": "201-567-0810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-07",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NJ",
            "license": "25ME00060401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.