Individual provider Active NPI

Kelly Mission, CRNP

  • Nurse Practitioner
  • Camden, NJ
National Provider Identifier
1144551276
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00901900 Issued in NJ
Practice address
1 Cooper PLZ
Camden, NJ 08103
Phone
(856) 342-2351
NPI assigned
Jan 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ00901900 NJ Primary
Family Nurse Practitioner 363LF0000X SP010708 PA

Addresses

Primary practice location

1 Cooper PLZ
Camden, NJ 08103

Mailing address

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

Other practice location 1

111 S 11th St
Philadelphia, PA 19107-4824
Phone (609) 553-9490

Other practice location 2

111 S 11th St
Philadelphia, PA 19107-4824
Phone (609) 553-9490

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
I20190426000225 NJ Practitioner - Nurse Practitioner 3375702327 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-County Health Connections, PCGroup PAC ID 8022271410, 17 clinicians

Practice addresses (Care Compare)

1120 Delsea Dr N
Glassboro, NJ 08028-1444
Phone (856) 507-2783

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00901900NJMDNurse Practitioner
SP010708PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-County Health Connections PC CurrentSince May 1, 2023 Accepting new patients
Medical Director Services PC CurrentSince May 8, 2020 Accepting new patients
Senacare, LLC CurrentSince Aug 2, 2021 Accepting new patients
Cooper Univeristy Emergency Physicians, PC CurrentSince Mar 5, 2019 Accepting new patients
Cooper Urgent Care, PC CurrentSince Mar 5, 2019 Accepting new patients
Senacare, LLC CurrentSince Aug 2, 2021 Accepting new patients
Tri-County Health Connections PC Past Accepting new patients

Locations

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

2001 Route 70 E
Cherry Hill, NJ 08003
Phone (856) 396-6257

195 Route 130 S
Cinnaminson, NJ 08077
Phone (856) 735-6700

1120 Delsea Dr N
Fl 2
Glassboro, NJ 08028
Phone (856) 595-9136

1120 Delsea Dr N
Glassboro, NJ 08028
Phone (856) 205-7071

43 N White Horse Pike
Hammonton, NJ 08037
Phone (609) 567-3100

310 Salem Woodstown Rd
Salem, NJ 08079
Phone (856) 339-6054

1511 Clements Bridge Rd
Woodbury, NJ 08096
Phone (856) 513-4124

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1144551276",
    "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": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "08103",
            "telephone_number": "856-342-2351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 S 11th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074824",
            "country_code": "US",
            "telephone_number": "609-553-9490",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 S 11th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074824",
            "country_code": "US",
            "telephone_number": "609-553-9490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISSION",
        "first_name": "KELLY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-29",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00901900",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP010708",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.