NPIMap

Organization Active NPI

Kennedy Health System Assisted Living

  • Assisted Living Facility
  • Cherry Hill, NJ
National Provider Identifier
1699846113
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
NJ15A111 Issued in NJ
Legal business name
KENNEDY HEALTH SYSTEM ASSISTED LIVING
Practice address
.3501 West Chapel Avenue
Cherry Hill, NJ 08022
Phone
(856) 667-6826
Fax
(856) 667-6907
NPI assigned
Nov 13, 2006
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. Richard Koss
Title
VP Ambulatory Services
Phone
(856) 566-5279

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NJ15A111 NJ Primary

Addresses

Primary practice location

.3501 West Chapel Avenue
Cherry Hill, NJ 08022

Mailing address

1099 White Horse Rd
Voorhees, NJ 08043-4405
Phone (856) 566-2092

Other identifiers 1

IdentifierTypeStateIssuer
8344906MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Kennedy Neph Hyper Asso15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699846113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 WHITE HORSE RD",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434405",
            "telephone_number": "856-566-2092",
            "fax_number": "856-566-5288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": ".3501 WEST CHAPEL AVENUE",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "08022",
            "telephone_number": "856-667-6826",
            "fax_number": "856-667-6907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY HEALTH SYSTEM ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOSS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "VP AMBULATORY SERVICES",
        "authorized_official_telephone_number": "856-566-5279",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NJ",
            "license": "NJ15A111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8344906",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, 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.