Kennedy Wound Care Center

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

MB05205500 Issued in NJ

Legal business name

KENNEDY WOUND CARE CENTER

Practice address

33 Castleton LN
Moorestown, NJ 08057-3049

Phone

(856) 638-0108

NPI assigned

Jan 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Catherine Ann Barone, D.O.

Title

Supervising Hyperbaric Physician

Phone

(856) 256-2063

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Charles L Dietzek3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Charles L Dietzek, DO, Facos, PC

  • Vascular Surgery Physician
  • Voorhees, NJ
  • NPI 1306905658
  NPD tax ID
• Charles L. Dietzek

  • Vascular Surgery Physician
  • Sewell, NJ
  • NPI 1861545188
  NPD tax ID

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1760537930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "543 EGG HARBOR RD",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802335",
            "telephone_number": "856-256-2063",
            "fax_number": "856-256-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 CASTLETON LN",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573049",
            "telephone_number": "856-638-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY WOUND CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "BARONE",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "SUPERVISING HYPERBARIC PHYSICIAN",
        "authorized_official_telephone_number": "856-256-2063",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NJ",
            "license": "MB05205500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Jason Kehler
• Oumou Keita, MD
• Christopher Keller, OTR/L
• Brittany Kendall, COTA
• Jessica Lynn Kendall, RN
• Lauren Kerner, PT
• Tanner Kerr, DPT, PT
• Zebaysh Khan, PA-C
• Jennifer Lynn Khelil, D.O.
• Kids and Families First Inc

• Clinic/Center in Moorestown, NJ
• Providers in Moorestown, NJ by specialty
• Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.