Kiersten Ilaoa

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ00952100 Issued in NJ

Practice address

765 Route 70 E
Marlton, NJ 08053-2341

Phone

(856) 983-3900

NPI assigned

Jul 2, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kiersten.ilaoa.p1@direct.cfg.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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

• Center for Family Guidance, PC

  • Geriatric Psychiatry Physician
  • Marlton, NJ
  • NPI 1508803388

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Anchored Adolescent & Child Psychiatry LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Marmora, NJ
  • NPI 1205682622
  NPD Authorized official
• Center for Family Guidance, PC

  • Clinical Social Worker
  • Mays Landing, NJ
  • NPI 1881759306
  NPD (past)

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1710549431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 ROUTE 70 E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532341",
            "telephone_number": "856-983-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 ROUTE 70 E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532341",
            "telephone_number": "856-983-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILAOA",
        "first_name": "KIERSTEN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00952100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentailing@cfgpc.com",
            "affiliation": "Y",
            "affiliationName": "Center for Family Guidance, PC",
            "address_1": "765 Route 70 E",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080532341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Richard James Huynh
• Hydration Clinics of America
• I. Harvey Getzoff, PA
• Madison Caroline Iannotta
• Kennedy M Ilagan, PT/DPT
• Heather Lisa Ilconich, LCSW
• In This Moment Recovery
• Inadvance Medicine Associates East (Passport Health)
• Inandout Enterprises LLC (Peak Mental Health LLC)
• Inclusive Care Counseling

• Psychiatric/Mental Health Nurse Practitioner in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.