KENNEDY MEDICAL GROUP PRACTICE, P.C. (NPI# 1578975520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578975520 |
| Entity Type | Organization |
| Organization Name | KENNEDY MEDICAL GROUP PRACTICE, P.C. |
| Other Organization Name | D/B/A/ KENNEDY HEALTH ALLIANCE |
| Practice Address |
485 Williamstown Road Sicklerville NJ 08081 |
| Mailing Address |
205 E. Laurel Road 2nd Floor Statford NJ 08084 |
| Practice Telephone | 8567729600 |
| Practice Fax Number | 8567729650 |
| Mailing Telephone | 8567831987 |
| Mailing Fax Number | 8567831403 |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2014-05-27 |
| Authorized Official Name | KATHERINE SCHLEIDER (VPCLINICAL INTEGRATION & POPULATION) |
| Authorized Official Telephone | 8567831987 |
| Is Organization Subpart | Y |
| Parent Organization Name | KENNEDY MEDICAL GROUP PRACTICE, P.C. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 25MB03854300 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | RAILROAD MEDICARE | P00633440 | 01 |
| NJ | 3911101 | 05 |
| Other Name | Type Code |
|---|---|
| d/b/a/ Kennedy Health Alliance | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669847646 | Kennedy Medical Group Practice, P.C. | Internal Medicine | 2211 Chapel Ave West, Ste 301, Cherry Hill, NJ 08002 | 2015-12-02 |
| 1629343421 | Kennedy Medical Group Practice, P.C. | Surgery | 543 Egg Harbor Road, Sewell, NJ 08080-2335 | 2012-03-13 |
| 1558727677 | Kennedy Medical Group Practice, P.C. | Surgery | 333 Laurel Oak Rd, Voorhees, NJ 08043-4453 | 2016-01-05 |
| 1346615333 | Kennedy Medical Group Practice, P.C. | Internal Medicine | 457 Haddonfield Rd, Ste. 110, Cherry Hill, NJ 08002-2220 | 2015-12-02 |
| 1902271992 | Kennedy Medical Group Practice, P.C. | Surgery | 668 Main St, Ste. 4, Lumberton, NJ 08048-5016 | 2015-12-02 |
| 1003281080 | Kennedy Medical Group Practice, P.C. | Surgery | 570 Egg Harbor Rd, Suite C-2, Sewell, NJ 08080-2359 | 2015-12-02 |
| 1932511987 | Kennedy Medical Group Practice, P.C. | Obstetrics & Gynecology | 188 Fries Mill Rd, Suite N3, Blackwood, NJ 08012-2015 | 2014-05-27 |
| 1164834297 | Kennedy Medical Group Practice, P.C. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2301 Evesham Road, Suite 406, Voorhees, NJ 08043 | 2014-05-23 |
| 1255743357 | Kennedy Medical Group Practice, P.C. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 524 Williamstown Road, Sicklerville, NJ 08081 | 2014-05-22 |
| 1952726796 | Kennedy Medical Group Practice, P.C. | Hospitalist | 333 Laurel Oak Rd, Voorhees, NJ 08043-4453 | 2014-03-04 |
| Street Address |
485 WILLIAMSTOWN ROAD |
| City | SICKLERVILLE |
| State | NJ |
| Zip Code | 08081 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771031 | Clack Associates, LLC. | Counselor | 603 Liberty Place, Sicklerville, NJ 08081 | 2019-10-13 |
| 1164901351 | Devereux Foundation | Day Training, Developmentally Disabled Services | 1601 - 1603 Sicklerville Road, Sicklerville, NJ 08081 | 2018-08-09 |
| 1467930990 | Brooke Schatzman | Lactation Consultant, Non-RN | 112 Hampton Court, Sicklerville, NJ 08081 | 2018-08-06 |
| 1831686443 | Grandular Senior Living | Day Training/Habilitation Specialist | 542 Berlin Cross Key Road Ste 3-270, Sicklerville, NJ 08081 | 2018-04-18 |
| 1942718465 | Community Dental of Sicklerville, P.C. | Dentist | 513 Cross Keys Road, Sicklerville, NJ 08081 | 2018-01-18 |
| 1831609304 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10 Brandon Court, Sicklerville, NJ 08081 | 2017-10-10 |
| 1710402631 | Premiere Behavioral Supports | Behavior Technician | 404 Independence Blvd, Sicklerville, NJ 08081 | 2017-08-11 |
| 1285167346 | A Better Concept | Community/Behavioral Health | 20 Wildcat Branch Dr, Sicklerville, NJ 08081 | 2017-04-06 |
| 1558712299 | Shaquira Briggs | Counselor | 40 Vernon Court, Sicklerville, NJ 08081 | 2016-06-23 |
| 1588012496 | Grace Musokae | Pharmacist | 412 Sicklerville Rd, Jolin's Pharmacy #103, Sicklerville, NJ 08081 | 2016-06-01 |
| Find all providers in zip 08081 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255743357 | Kennedy Medical Group Practice, P.C. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 524 Williamstown Road, Sicklerville, NJ 08081 | 2014-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073057543 | Mohamed Abbassi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 91 Goodwin Dr, North Brunswick, NJ 08902-4273 | 2016-12-18 |
| 1770913782 | Advanced Cardiovascular Specialists LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 12 Brown Ct, Livingston, NJ 07039-1520 | 2013-11-13 |
| 1346687647 | Leonid Emerel | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 54 Mccampbell Rd, Holmdel, NJ 07733-2229 | 2013-05-28 |
| 1477899607 | Hudson Cardiothoracic Surgery, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4 Bucks Mill Ln, Holmdel, NJ 07733-1756 | 2012-12-16 |
| 1801194659 | Mamsurg Thoracic Surgery LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4013 Us Highway 9, Howell, NJ 07731-4021 | 2011-03-03 |
| 1538472873 | Ronald E Ross | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 200 Trenton Rd - Deborah Heart & Lung Center, Mid Atlantic Surgical Associates, Browns Mills, NJ 08015 | 2010-07-15 |
| 1962727644 | Benjamin Van Boxtel | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Mid-atlantic Surgical Associates, 100 Madison Avenue, Morristown, NJ 07960 | 2010-04-06 |
| 1699003145 | Douglas Joseph Dipaola | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5 Fullerton Rd, Moorestown, NJ 08057-1926 | 2009-11-20 |
| 1770810749 | James Clark Hart | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 37 Hurlingham Club Rd, Far Hills, NJ 07931-2479 | 2009-11-11 |
| 1386977916 | Princeton Cardiac and Thoracic Surgery Associates | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 253 Witherspoon St Ste F, Princeton, NJ 08540-3211 | 2009-09-15 |
| Find all providers with the same taxonomy | ||||
| City | SICKLERVILLE |
| Zip Code | 08081 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.