NPIMap

Organization Active NPI

Kennedy University Hospital Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Sewell, NJ
National Provider Identifier
1366533770
Registry record updated Dec 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
1080 Issued in NJ
Legal business name
KENNEDY UNIVERSITY HOSPITAL INC.
Practice address
300 Medical Center Drive
Suite a
Sewell, NJ 08080-2373
Phone
(856) 218-4990
Fax
(856) 256-9624
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2010

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

Authorized official

Name
Mr. Joseph Lario
Title
Chief Financial Officer
Phone
(856) 661-5144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 1080 NJ Primary

Addresses

Primary practice location

300 Medical Center Drive
Suite a
Sewell, NJ 08080-2373

Mailing address

PO Box 13703
Philadelphia, PA 19101-3703
Phone (856) 661-5164

Other identifiers 1

IdentifierTypeStateIssuer
4140206MedicaidNJ

Other names 1

  • Kennedy Dialysis Center - Washington Township Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291939200000",
    "number": "1366533770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13703",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191013703",
            "telephone_number": "856-661-5164",
            "fax_number": "856-661-5274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL CENTER DRIVE",
            "address_2": "SUITE A",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802373",
            "telephone_number": "856-218-4990",
            "fax_number": "856-256-9624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY UNIVERSITY HOSPITAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2010-12-10",
        "status": "A",
        "authorized_official_last_name": "LARIO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "856-661-5144",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NJ",
            "license": "1080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4140206",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kennedy Dialysis Center - Washington Township",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sewell, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2010; 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.