Kadyija Caressa Lawrence, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP030549 Issued in PA

Practice address

1500 Chestnut St
Suite 2 #1266
Philadelphia, PA 19102

Phone

(267) 250-8098

NPI assigned

Sep 18, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ennoble HC NJ PCGroup PAC ID 0345638185, 129 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ennoble HC NJ PC

  • Geriatric Medicine (Family Medicine) Physician
  • Hackensack, NJ
  • NPI 1306500764

  PA

  Medicare reassignment Care Compare group NPD
• Ennoble HC NJ II PC

  • Geriatric Medicine (Family Medicine) Physician
  • Hackensack, NJ
  • NPI 1871475806

  PA

  Medicare reassignment NPD
• Ennoble HC NJ III PC

  • Geriatric Medicine (Family Medicine) Physician
  • Hackensack, NJ
  • NPI 1043192099

  PA

  Medicare reassignment NPD

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1619704129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 CHESTNUT ST",
            "address_2": "SUITE 2 #1266",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CHESTNUT ST",
            "address_2": "SUITE 2 #1266",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "267-250-8098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "KADYIJA",
        "middle_name": "CARESSA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP030549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Lawrence, CRNA
• Diana Lawrence
• Diane Lawrence, CRNA
• Donald R Lawrence, PA-C
• John Todd Rutter Lawrence, M.D./PH.D.
• Kendall McCarthy Lawrence, MD
• O'Nisha Shanette Lawrence, MD
• Renee Lawrence
• Richard James Lawrence, MA MBBS MRCP
• Zachary Lawrence, MD

• Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.