NPIMap

Organization Active NPI

Kennedy Medical Group Practice, P.C. D/B/a Kennedy Health Alliance

  • Pulmonary Disease Physician
  • Stratford, NJ
National Provider Identifier
1619365152
Registry record updated Jan 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
25MB03744500 Issued in NJ
Legal business name
KENNEDY MEDICAL GROUP PRACTICE, P.C. D/B/A KENNEDY HEALTH ALLIANCE
Practice address
205 E Laurel Rd
Stratford, NJ 08084-1301
Phone
(856) 783-1987
NPI assigned
Jan 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2015

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

Authorized official

Name
Katherine Schleider, VP
Title
Clinical Integration&Populationheal
Phone
(856) 783-1987

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X 25MB03744500 NJ Primary

Addresses

Primary practice location

205 E Laurel Rd
Stratford, NJ 08084-1301

Mailing address

1A Regulus Drive
Turnersville, NJ 08012
Phone (856) 553-6904

National Provider Directory

National Provider Directory
Tax ID family
Kennedy Medical Group Practice PC Dba Kennedy Health Alliance36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1420588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420588800000",
    "number": "1619365152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A REGULUS DRIVE",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "08012",
            "telephone_number": "856-553-6904",
            "fax_number": "856-589-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E LAUREL RD",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841301",
            "telephone_number": "856-783-1987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY MEDICAL GROUP PRACTICE, P.C. D/B/A KENNEDY HEALTH ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-07",
        "last_updated": "2015-01-07",
        "status": "A",
        "authorized_official_last_name": "SCHLEIDER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "CLINICAL INTEGRATION&POPULATIONHEAL",
        "authorized_official_telephone_number": "856-783-1987",
        "authorized_official_credential": "VP"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MB03744500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; 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.