Organization Active NPI

Kenneth a. Leight PHD New Roads LLC

  • Psychologist
  • Linwood, NJ
National Provider Identifier
1811298649
Registry record updated Nov 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35SI00255900 Issued in NJ
Legal business name
KENNETH A. LEIGHT PHD NEW ROADS LLC
Practice address
2106 New Rd
Suite F3
Linwood, NJ 08221-1046
Phone
(609) 926-1165
Fax
(609) 926-1228
NPI assigned
Nov 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2010

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

Authorized official

Name
Kenneth Leight, PHDNPI 1871527663
Title
Psychologist
Phone
(609) 926-1165

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 35SI00255900 NJ Primary

Addresses

Primary practice location

2106 New Rd
Suite F3
Linwood, NJ 08221-1046

Mailing address

2106 New Rd
Suite F3
Linwood, NJ 08221-1046
Phone (609) 926-1165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101123001012 NJ Part B Supplier - Clinic/Group Practice 0042406571 Receives reassigned benefits from 1 practitioner
Practice locations: Linwood, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289347200000",
    "number": "1811298649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 NEW RD",
            "address_2": "SUITE F3",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082211046",
            "telephone_number": "609-926-1165",
            "fax_number": "609-926-1228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 NEW RD",
            "address_2": "SUITE F3",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082211046",
            "telephone_number": "609-926-1165",
            "fax_number": "609-926-1228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH A. LEIGHT PHD NEW ROADS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-10",
        "last_updated": "2010-11-10",
        "status": "A",
        "authorized_official_last_name": "LEIGHT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "609-926-1165",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00255900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Linwood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.