NPIMap

Individual provider Active NPI

Teresa Coyle, DO

  • Family Medicine Physician
  • Cherry Hill, NJ
National Provider Identifier
1932661618
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB11774600 Issued in NJ
Practice address
457 Haddonfield Rd Ste 110
Cherry Hill, NJ 08002-2223
Phone
(844) 542-2273
NPI assigned
Apr 2, 2019
Last updated
Sep 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB11774600 NJ Primary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 25MB11774600 NJ

Addresses

Primary practice location

457 Haddonfield Rd Ste 110
Cherry Hill, NJ 08002-2223

Mailing address

457 Haddonfield Rd Ste 110
Cherry Hill, NJ 08002-2223

Other practice location 1

4300 Londonderry Road
Harrisburg, PA 17109
Phone (412) 647-5815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230626003185 NJ Practitioner - Family PracticePractitioner - Sports Medicine 2668853391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Lake Erie Col of Osteo Med at Seton Hill Univ, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

457 Haddonfield Rd
Suite 110
Cherry Hill, NJ 08002-2223
Phone (844) 542-2273

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
25MB11774600NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Medical Group Practice, P.C. Family Medicine CurrentSince Aug 1, 2023 Accepting new patients
Kennedy Medical Group Practice, P.C. Family Medicine Current Accepting new patients
Kennedy Medical Group Practice PC Family Medicine CurrentSince Aug 1, 2023 Accepting new patients
Kennedy Medical Group Practice P.C. Family Medicine Past Accepting new patients

Locations

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

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

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1932661618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 HADDONFIELD RD STE 110",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080022223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 HADDONFIELD RD STE 110",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080022223",
            "telephone_number": "844-542-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4300 Londonderry Road",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "17109",
            "country_code": "US",
            "telephone_number": "412-647-5815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COYLE",
        "first_name": "TERESA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB11774600",
            "primary": true
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NJ",
            "license": "25MB11774600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.