NPIMap

Organization Active NPI

Camcare Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Camden, NJ
National Provider Identifier
1023347242
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
24326 Issued in NJ
Legal business name
CAMCARE HEALTH CORPORATION
Practice address
813 Ferry Ave
Camden, NJ 08104-1824
Phone
(856) 602-4012
NPI assigned
Dec 17, 2009
Last updated
Dec 6, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
CAMCARE HEALTH CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Authorized official

Name
Ms. Jhoanna L Engelhardt
Title
Director of Human Resources
Phone
(856) 583-2491

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 24326 NJ Primary

Addresses

Primary practice location

813 Ferry Ave
Camden, NJ 08104-1824

Mailing address

817 Federal Street
Suite 300
Camden, NJ 08103
Phone (856) 541-5933

Other identifiers 1

IdentifierTypeStateIssuer
0227439MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040130000243 NJ Part B Supplier - Clinic/Group Practice 2567365117 Receives reassigned benefits from 89 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Camden, NJ; Clementon, NJ; Paulsboro, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023347242. Details of each certification follow.

  • CCN 311896 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 311896

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CAMCARE-ODESSA PAULK-JONES HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 15, 2011
Last certification
Nov 15, 2011
Ownership / control type
For profit – corporation
Facility address
813 Ferry Avenue
Camden, NJ 08104
Related CCNs
311815

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Camcare Health Corp

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733443200000",
    "number": "1023347242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 FEDERAL STREET",
            "address_2": "SUITE 300",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "08103",
            "telephone_number": "856-541-5933",
            "fax_number": "856-541-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 FERRY AVE",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081041824",
            "telephone_number": "856-602-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMCARE HEALTH CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAMCARE HEALTH CORPORATION",
        "enumeration_date": "2009-12-17",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A",
        "authorized_official_last_name": "ENGELHARDT",
        "authorized_official_first_name": "JHOANNA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF HUMAN RESOURCES",
        "authorized_official_telephone_number": "856-583-2491",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NJ",
            "license": "24326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0227439",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.