Active NPI
Melissa Kavanaugh
- Registered Dietitian
- Haddon Heights, NJ
National Provider Identifier
1720533953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86037064
- Practice address
- 6 White Horse Pike
Suite 1B
Haddon Heights, NJ 08035-1246 - Phone
- (856) 617-1012
- NPI assigned
- Aug 17, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86037064 | Primary |
Addresses
Primary practice location
6 White Horse Pike
Suite 1B
Haddon Heights, NJ 08035-1246
Mailing address
8 Knollwood Dr
Cherry Hill, NJ 08002-1618
Other practice location 1
570 Egg Harbor Rd Ste C2
Sewell, NJ 08080-2359
Phone (856) 256-7777
Other practice location 2
2211 Chapel Ave West
Suite 301
Cherry Hill, NJ 08002
Phone (856) 665-2017
Other practice location 3
333 Laurel Oak Rd
Voorhees, NJ 08043-4453
Phone (856) 665-2017
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kennedy Medical Group Practice, P.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Voorhees, NJ
- NPI 1952726796
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1720533953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 KNOLLWOOD DR",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "080021618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 WHITE HORSE PIKE",
"address_2": "SUITE 1B",
"city": "HADDON HEIGHTS",
"state": "NJ",
"postal_code": "080351246",
"telephone_number": "856-617-1012"
}
],
"practiceLocations": [
{
"address_1": "570 Egg Harbor Rd Ste C2",
"address_purpose": "LOCATION",
"city": "Sewell",
"state": "NJ",
"postal_code": "080802359",
"country_code": "US",
"telephone_number": "856-256-7777",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2211 Chapel Ave West",
"address_2": "Suite 301",
"address_purpose": "LOCATION",
"city": "Cherry Hill",
"state": "NJ",
"postal_code": "08002",
"country_code": "US",
"telephone_number": "856-665-2017",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "333 Laurel Oak Rd",
"address_purpose": "LOCATION",
"city": "Voorhees",
"state": "NJ",
"postal_code": "080434453",
"country_code": "US",
"telephone_number": "856-665-2017",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KAVANAUGH",
"first_name": "MELISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-17",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "86037064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Haddon Heights, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.