NPIMap

Organization Active NPI

KJC Medi Weightloss LLC

Doing business as Mediweightloss of Wakefield

  • Family Medicine Physician
  • Wakefield, MA
National Provider Identifier
1336692243
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
50673 Issued in MA
Legal business name
KJC MEDI WEIGHTLOSS LLC
Doing business as
Mediweightloss of Wakefield
Practice address
603 Salem St
Wakefield, MA 01880-1227
Phone
(781) 245-6334
NPI assigned
Jul 27, 2016
Last updated
Sep 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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

Authorized official

Name
Dr. Jeanne Marie Kilp, ACOGNPI 1669490801
Title
Medical Director
Phone
(781) 245-6334

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 50673 MA Primary

Addresses

Primary practice location

603 Salem St
Wakefield, MA 01880-1227

Mailing address

603 Salem St
Wakefield, MA 01880-1227
Phone (781) 245-6334

Other names 1

  • Mediweightloss of Wakefield Doing business as

National Provider Directory

National Provider Directory

Locations

603 Salem St
Wakefield, MA 01880
Phone (781) 245-6334

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475020800000",
    "number": "1336692243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 SALEM ST",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018801227",
            "telephone_number": "781-245-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 SALEM ST",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018801227",
            "telephone_number": "781-245-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KJC MEDI WEIGHTLOSS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-27",
        "last_updated": "2016-09-28",
        "status": "A",
        "authorized_official_last_name": "KILP",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "781-245-6334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ACOG"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "50673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mediweightloss of Wakefield",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wakefield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; 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.