Individual provider Active NPI

Kristie Anne McNally, FNP

  • Family Nurse Practitioner
  • Marlton, NJ
National Provider Identifier
1841700952
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00857100 Issued in NJ
Practice address
73 N Maple Ave Ste B
Marlton, NJ 08053-1782
Phone
(844) 542-2273
NPI assigned
Oct 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NR18188800 NJ
Family Nurse Practitioner 363LF0000X 26NJ00857100 NJ Primary

Addresses

Primary practice location

73 N Maple Ave Ste B
Marlton, NJ 08053-1782

Mailing address

73 N Maple Ave Ste B
Marlton, NJ 08053-1782
Phone (844) 542-2273

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
I20190409000363 NJ Practitioner - Nurse Practitioner 4486995065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

73 N Maple Ave B
Kennedy Health Alliance
Marlton, NJ 08053-1782
Phone (844) 542-2273

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NR18188800NJMDRegistered Nurse
26NJ00857100NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Medical Group Practice, P.C. CurrentSince Apr 1, 2019 Accepting new patients
Kennedy Medical Group Practice PC CurrentSince Apr 1, 2019 Accepting new patients
Kennedy Medical Group Practice P.C. Past Accepting new patients

Locations

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

73 N Maple Ave
Ste B
Marlton, NJ 08053
Phone (856) 596-0558

73 N Maple Ave
Marlton, NJ 08053
Phone (856) 352-6660

151 Fries Mill Rd
Ste 301
Turnersville, NJ 08012
Phone (856) 374-1881

400 Laurel Oak Rd
Ste 105
Voorhees, NJ 08043
Phone (609) 304-0991

Organizations & group practices 3

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 5

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": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1841700952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 N MAPLE AVE STE B",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531782",
            "telephone_number": "844-542-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 N MAPLE AVE STE B",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531782",
            "telephone_number": "844-542-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNALLY",
        "first_name": "KRISTIE",
        "middle_name": "ANNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-03",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR18188800",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00857100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.