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Physician • Cherry Hill, NJ

Active NPI 1710551460 Individual Practitioner Male Practitioner
Practice location in NPPES

1305 Kings Hwy N
Cherry Hill, NJ 080341919

Call 8566517826 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1305 Kings Hwy N

Cherry Hill, NJ 080341919

Telephone 8566517826
Fax 8562297142
Organization at the Same NPPES Address or Phone
Marlton Medical Group, P.c. Facility NPI 1245397645

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2021

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2021-05-17
Clinic/Center - Methadone Primary Specialty

NUCC Taxonomy Code: 261QM2800X

License # reported to NPPES NJ 2000872

An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: New Jersey Division of Consumer Affairs.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
2000872 (NJ)

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
Dr. Kenneth Brown , MD

Emergency Medicine

NPI 1164521084

Doctor of Medicine (M.D.)

Career & Practice History

NPI enumerated May 18, 2021.

No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from June 2021 to August 2026.

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NPI Administrative Meta

NPI Number: 1710551460
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 18, 2021
Last Update: May 18, 2021
Sole Proprietor: Yes

Mailing Address

1305 Kings Hwy N

Cherry Hill, NJ 080341919

Phone: 8566517826

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.