NPIMap

Organization Active NPI

Kennedy Surgical Center

  • Ambulatory Surgical Clinic/Center
  • Sewell, NJ
National Provider Identifier
1629187125
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
82444 Issued in NJ
Legal business name
KENNEDY SURGICAL CENTER
Practice address
540 Egg Harbor Rd
Sewell, NJ 08080-2336
Phone
(856) 218-4900
Fax
(856) 256-1276
NPI assigned
Aug 29, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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
Ambulatory Surgical Clinic/Center 261QA1903X 82444 NJ Primary

Addresses

Primary practice location

540 Egg Harbor Rd
Sewell, NJ 08080-2336

Mailing address

PO Box 48023
Newark, NJ 07101-4823
Phone (856) 661-5164

Other identifiers 1

IdentifierTypeStateIssuer
7251009MedicaidNJ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629187125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 48023",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071014823",
            "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": "540 EGG HARBOR RD",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802336",
            "telephone_number": "856-218-4900",
            "fax_number": "856-256-1276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY SURGICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2020-08-22",
        "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": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NJ",
            "license": "82444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7251009",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.