Individual provider Active NPI

Kelly Kerrigan, APN

  • Adolescent and Children Mental Health Clinic/Center
  • Cinnaminson, NJ
National Provider Identifier
1780130989
Registry record updated Aug 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
101970104 Issued in NJ
Practice address
101 US Route 130
Cinnaminson, NJ 08077
Phone
(609) 933-7044
NPI assigned
Aug 28, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 101970104 NJ Primary

Addresses

Primary practice location

101 US Route 130
Cinnaminson, NJ 08077

Mailing address

101 US Route 130
Cinnaminson, NJ 08077
Phone (609) 933-7044

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170905000303 NJ Practitioner - Nurse Practitioner 9335412980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Family Guidance PCGroup PAC ID 2860396454, 164 clinicians

Practice addresses (Care Compare)

765 Route 70 E
BLDG a
Marlton, NJ 08053-2341
Phone (856) 983-3900

Hospital & facility affiliations

  • Inspira Medical Center Mullica Hill Hospital, Elmer, NJ, CCN 310069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
101970104NJMDAdolescent and Children Mental Health Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Family Guidance, PC CurrentSince Jul 4, 2017 Accepting new patients

Locations

333 Irving Ave
Bridgeton, NJ 08302
Phone (856) 575-4500

765 Route 70 E
Bldg A
Marlton, NJ 08053
Phone (856) 797-4721

Interoperability endpoints

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

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472342400000",
    "number": "1780130989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 US ROUTE 130",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "08077",
            "telephone_number": "609-933-7044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 US ROUTE 130",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "08077",
            "telephone_number": "609-933-7044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERRIGAN",
        "first_name": "KELLY",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NJ",
            "license": "101970104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cinnaminson, NJ

Sources for this page

Verify at the official NPI Registry.