Individual provider Active NPI

Kathryn Mary Lederer, DC

  • Chiropractor
  • Guttenberg, NJ
National Provider Identifier
1578292934
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00790400 Issued in NJ
Practice address
7000 Boulevard E Ste M-9
Guttenberg, NJ 07093-4825
Phone
(201) 305-3591
NPI assigned
Jun 9, 2022
Last updated
Jul 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 38MC00790400 NJ
Pediatric Chiropractor 111NP0017X 38MC00790400 NJ
Radiology Chiropractor 111NR0200X 38MC00790400 NJ
Chiropractor 111N00000X 38MC00790400 NJ Primary

Addresses

Primary practice location

7000 Boulevard E Ste M-9
Guttenberg, NJ 07093-4825

Mailing address

PO Box 252
Budd Lake, NJ 07828-0252
Phone (908) 399-1600

Other practice location 1

125 US Highway 46 Ste 3
Budd Lake, NJ 07828-2523
Phone (201) 305-3591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
38MC00790400NJMDNutrition Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1578292934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 252",
            "city": "BUDD LAKE",
            "state": "NJ",
            "postal_code": "078280252",
            "telephone_number": "908-399-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 BOULEVARD E STE M-9",
            "city": "GUTTENBERG",
            "state": "NJ",
            "postal_code": "070934825",
            "telephone_number": "201-305-3591"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 US Highway 46 Ste 3",
            "address_purpose": "LOCATION",
            "city": "Budd Lake",
            "state": "NJ",
            "postal_code": "078282523",
            "country_code": "US",
            "telephone_number": "201-305-3591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEDERER",
        "first_name": "KATHRYN",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-09",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "NJ",
            "license": "38MC00790400",
            "primary": false
        },
        {
            "code": "111NP0017X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "NJ",
            "license": "38MC00790400",
            "primary": false
        },
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "NJ",
            "license": "38MC00790400",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00790400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guttenberg, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.