Kimberly Jeanne Deery, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MB09678700 Issued in NJ

Practice address

63 N Lakeview Dr
Suite 202
Gibbsboro, NJ 08026-1026

Phone

(856) 435-6000

Fax

(856) 782-1667

NPI assigned

Oct 30, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Jeanne Young Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberly.deery@advocaredoctors.eclinicaldirectplus.com

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.

• Advocare, LLC

  • Pediatrics Physician
  • Marlton, NJ
  • NPI 1770538696
  Medicare reassignment NPD
• Advocare , LLC

  • Internal Medicine Physician
  • Manahawkin, NJ
  • NPI 1912762162
  NPD
• Advocare, LLC

  • Pediatrics Physician
  • Cherry Hill, NJ
  • NPI 1780696732
  NPD (past)

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

{
    "created_epoch": "1319932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1992081392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 N LAKEVIEW DR",
            "address_2": "SUITE 202",
            "city": "GIBBSBORO",
            "state": "NJ",
            "postal_code": "080261026",
            "telephone_number": "856-435-6000",
            "fax_number": "856-782-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 N LAKEVIEW DR",
            "address_2": "SUITE 202",
            "city": "GIBBSBORO",
            "state": "NJ",
            "postal_code": "080261026",
            "telephone_number": "856-435-6000",
            "fax_number": "856-782-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEERY",
        "first_name": "KIMBERLY",
        "middle_name": "JEANNE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-30",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MB09678700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "YOUNG",
            "middle_name": "JEANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chop Clinical Associates, PC
• Janice Christiansen, L.G.C.
• Clinical Therapeutics, LLC
• Gerard Corsi Jr., D.M.D.
• Debra Malley, MD LLC
• Donald J Baker M D L L C
• Charmen W. Douglas, D.M.D
• Dr. Christopher M Larosa LLC
• Eihab Human Services New Jersey, Inc.
• Eihab Human Services New Jersey, Inc.

• Pediatrics Physician in Gibbsboro, NJ
• Providers in Gibbsboro, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.