KELLY KENNEDY (NPI# 1942801956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942801956 |
| Entity Type | Individual |
| Full Name | KELLY KENNEDY |
| Credential | MSN, RN-BC, NP-C |
| Practice Address |
223 N Van Dien Ave Ridgewood NJ 07450-2726 |
| Mailing Address |
818 Wynetta Pl Paramus NJ 07652-2325 |
| Practice Telephone | 2014478000 |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2020-11-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
26NJ01049200 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841818051 | Kelly Renee Kennedy | Specialist/Technologist | 720 N Noyes Blvd, Saint Joseph, MO 64506-2813 | 2020-07-14 |
| 1003474784 | Kelly Kennedy | Counselor | 236 Moultrie Pl, Santa Paula, CA 93060-3241 | 2019-05-29 |
| 1376973198 | Kelly Leigh Kennedy | Nurse Practitioner | 5600 Brainerd Road, Suite B14, Chattanooga, TN 37411 | 2013-11-14 |
| 1093967903 | Kelly Jean Kennedy | Physical Therapy Assistant | 1221 Corey Dr, Whitehouse, TX 75791-3731 | 2008-10-22 |
| 1174647689 | Kelly Kennedy | Occupational Therapist | N4901 Dam Rd, Delavan, WI 53115-2927 | 2007-03-19 |
| 1578572269 | Kelly David Kennedy | Chiropractor | 6 East First Avenue, Runnemede, NJ 08078-1101 | 2006-08-05 |
| 1689280406 | Kelly Marie Kennedy | Pharmacist | 500 W Grant St, Lake City, MN 55041-1143 | 2020-09-17 |
| 1427500701 | Kelly Kennedy | Registered Nurse | 3853 Rosecrans St, San Diego, CA 92110-3115 | 2016-11-02 |
| 1841654399 | Kelly Kennedy | Dietitian, Registered | 777 North St, Pittsfield, MA 01201-4147 | 2016-04-11 |
| 1063880136 | Kelly Kennedy | Occupational Therapy Assistant | 118 Medical Dr, Carmel, IN 46032-2923 | 2015-09-08 |
| Street Address |
223 N VAN DIEN AVE |
| City | RIDGEWOOD |
| State | NJ |
| Zip Code | 07450-2726 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306840913 | Donna Mae Rudesyle | Nurse Practitioner | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2005-06-10 |
| 1649889858 | Barbara Abboud | Pharmacist | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2020-07-24 |
| 1326668930 | Gita Natovich | Pharmacist | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2020-04-23 |
| 1255975926 | Gertrude Patria Borja | Nurse Practitioner | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2019-11-05 |
| 1386209229 | Benita Shaji Varghese | Nurse Practitioner | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2019-05-07 |
| 1750851481 | Joe Juliano | Dietitian, Registered | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2018-11-26 |
| 1558857748 | Amanda Ukleja | Physician Assistant | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2018-07-10 |
| 1528597218 | Leah Serviano | Registered Nurse | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2017-06-07 |
| 1306377569 | The Valley Hospital Inc. | Pharmacy | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2017-03-21 |
| 1083154520 | Karen Antler | Registered Nurse | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2017-03-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023675857 | Children's Aid and Family Services, Inc. | Behavioral Analyst | 213 Larue Road, W. Milford, NJ 07450 | 2019-05-28 |
| 1962065979 | Corey Chan | Student in an Organized Health Care Education/Training Program | 550 Lynn St, Ridgewood, NJ 07450 | 2019-04-16 |
| 1679058200 | Raymond Hawash | Pharmacist | 223 North Van Dien Ave, Ridgewood, NJ 07450 | 2018-09-28 |
| 1548771967 | Leonard Swerdlof | Dentist | 160 S Broad St, Ridgewood, NJ 07450 | 2017-10-12 |
| 1336671114 | Camp Sunshine and Camp Snowflake, Inc. | Respite Care | 1133 East Ridgewood Avenue, Ridgewood, NJ 07450 | 2017-03-30 |
| 1952764862 | Elysium Aesthetics and Vein Care, Inc | Radiology | 400 State Route 17, Ridgewood, NJ 07450 | 2016-03-30 |
| 1780077362 | Paul Walter Dasher | Psychologist | 76 West Ridgewood Avenue, Ridgewood, NJ 07450 | 2015-03-06 |
| 1255750071 | Myron Frank Lesh | Pharmacist | 305 E. Ridgewood Ave., Ridgewood, NJ 07450 | 2014-04-09 |
| 1649612912 | Jane Worthman-leva | Nutritionist | 357 South Irving St, Ridgewood, NJ 07450 | 2013-07-26 |
| 1427398858 | Life Opportunities Unlimited A Non Profit Corp. | Day Training, Developmentally Disabled Services | 75 North Maple Ave, Suite 104, Ridgewood, NJ 07450 | 2013-02-21 |
| Find all providers in zip 07450 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265080774 | Katherine Heeren | Nurse Practitioner | 1200 E Ridgewood Ave Ste 108, Ridgewood, NJ 07450-3937 | 2019-08-28 |
| 1518431865 | Julie M Grayson | Nurse Practitioner | 306 S Pleasant Ave, Ridgewood, NJ 07450-5334 | 2019-01-18 |
| 1457711095 | Jacqueline Therese Norrell | Nurse Practitioner | 217 Pershing Ave, Ridgewood, NJ 07450-2808 | 2016-02-24 |
| 1366097719 | Mingmar Doma Sherpa | Nurse Practitioner | 6655 Fresh Pond Rd, Ridgewood, NY 11385-3261 | 2019-08-02 |
| 1386209229 | Benita Shaji Varghese | Nurse Practitioner | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2019-05-07 |
| 1598278160 | Elizabeth Philip | Nurse Practitioner | 6115 Metropolitan Ave, Ridgewood, NY 11385-2644 | 2017-11-06 |
| 1730690231 | Casey Keegan | Nurse Practitioner | 615 Franklin Tpke, Ridgewood, NJ 07450-1903 | 2017-10-24 |
| 1114469962 | Milana Chulpayev | Nurse Practitioner | 6655 Fresh Pond Rd, Ridgewood, NY 11385-3261 | 2016-11-10 |
| 1598218158 | Nicole Waterhouse | Nurse Practitioner | 61 N Maple Ave, Suite 305, Ridgewood, NJ 07450-3255 | 2016-08-01 |
| 1801244173 | Krystle A Castillo | Nurse Practitioner | 1144 E Ridgewood Ave, Ridgewood, NJ 07450-3941 | 2016-05-27 |
| Find all providers in RIDGEWOOD | ||||
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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.