K Primary Care and Medical Nutrition Center

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

K PRIMARY CARE AND MEDICAL NUTRITION CENTER

Practice address

571 Central Ave
Suite 104
New Providence, NJ 07974-1547

Phone

(908) 206-4676

NPI assigned

Mar 30, 2015

Organization subpart

No

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

Authorized official

Name

Maureen Doherty

Title

Credentialing Contact

Phone

(908) 206-4676

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

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

• Kavita Rajiv Kewalramani, M.D.

  • Internal Medicine Physician
  • New Providence, NJ
  • NPI 1952528432
  Medicare reassignment NPD

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441065600000",
    "number": "1477948362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 CENTRAL AVE",
            "address_2": "SUITE 104",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079741547",
            "telephone_number": "908-206-4676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 CENTRAL AVE",
            "address_2": "SUITE 104",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079741547",
            "telephone_number": "908-206-4676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K PRIMARY CARE AND MEDICAL NUTRITION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-30",
        "last_updated": "2015-09-01",
        "status": "A",
        "authorized_official_last_name": "DOHERTY",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_title_or_position": "CREDENTIALING CONTACT",
        "authorized_official_telephone_number": "908-206-4676"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ariella Stefany Inzunza
• Rose Lerva Jean Baptiste
• Emily C Jefferson, PA-C
• Kelly Marie Jenner
• Erin Maggie Jones, PHARMD, MED, CSP
• Hayley Ann Kamis
• Karolina Nicewicz PSYD LLC
• Lorri B. Katz, RD, MA
• Johanna R. Kaufman, MD
• Kathryn L Kays, LCSW

• Internal Medicine Physician in New Providence, NJ
• Providers in New Providence, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.