Individual provider Active NPI

Regina Cameron, APN

  • Nurse Practitioner
  • Cherry Hill, NJ
National Provider Identifier
1104115922
Registry record updated May 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NJ00298800 Issued in NJ
Practice address
1030 N Kings Hwy
Suite 310
Cherry Hill, NJ 08034-1907
Phone
(856) 667-7266
Fax
(856) 779-9179
NPI assigned
Apr 1, 2011
Last updated
May 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NJ00298800 NJ Primary

Addresses

Primary practice location

1030 N Kings Hwy
Suite 310
Cherry Hill, NJ 08034-1907

Mailing address

1 Federal St # 200
Camden, NJ 08103-1088
Phone (856) 356-4924

Other identifiers 1

IdentifierTypeStateIssuer
NJ00298800OtherNJNURSING LICENSE

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110516000683 NJ Practitioner - Nurse Practitioner 3971789553 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cooper Nephrology PCGroup PAC ID 4385905017, 19 clinicians

Practice addresses (Care Compare)

3 Cooper PLZ
Camden, NJ 08103-1438
Phone (856) 667-7266

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NJ00298800NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Nephrology, PC CurrentSince Jan 1, 2018 Accepting new patients
CMC Department of Medicine Group PA CurrentSince Apr 4, 2011 Accepting new patients

Locations

1 Federal St
#200
Camden, NJ 08103

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

3 Cooper Plz
Rm 215
Camden, NJ 08103
Phone (856) 342-2439

1030 Kings Hwy N
Ste 310
Cherry Hill, NJ 08034
Phone (856) 667-7266

2339 Route 70 W
Ste 300
Cherry Hill, NJ 08002
Phone (856) 667-7266

5 Route 45
Ste 101
Salem, NJ 08079
Phone (856) 878-1500

Interoperability endpoints

  • Direct secure messaging: rcameron29716@direct.cooperhealth.edu

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1104115922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 N KINGS HWY",
            "address_2": "SUITE 310",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341907",
            "telephone_number": "856-667-7266",
            "fax_number": "856-779-9179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMERON",
        "first_name": "REGINA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-01",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "NJ00298800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING LICENSE",
            "identifier": "NJ00298800",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.