NPIMap

Organization Active NPI

Camcare Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Clementon, NJ
National Provider Identifier
1508035064
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
70471 Issued in NJ
Legal business name
CAMCARE HEALTH CORPORATION
Practice address
121 White Horse Pike
Clementon, NJ 08021-4158
Phone
(856) 541-5933
Fax
(856) 541-3340
NPI assigned
Feb 28, 2008
Last updated
Apr 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 70471 NJ Primary

Addresses

Primary practice location

121 White Horse Pike
Clementon, NJ 08021-4158

Mailing address

817 Federal St
Suite 300
Camden, NJ 08103-1539
Phone (856) 541-5933

Other identifiers 1

IdentifierTypeStateIssuer
0133752MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

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
O20070418000450 NJ Part A Provider - Federally Qualified Health Center (FQHC) 2567365117 1 other NPI on this enrollment
Practice locations: Clementon, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508035064. Details of each certification follow.

Federally qualified health center certification: CCN 311873

Legal name
CAMCARE HEALTH CORPORATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 23, 2007
Last certification
May 23, 2007
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 10, 1978 in NJ
Enrollment address
121 White Horse Pike
Clementon, NJ 80214158

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
Tax ID family
Camcare Health Corp5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Raynaldo Santiago Individual Corporate Director Apr 7, 2007
Jannette Ramos Individual Corporate Director Apr 2, 2007
Duane Myers Individual Corporate DirectorChairman of the Board Oct 1, 2020
James Miles Individual Corporate Director Oct 1, 2020
Scott Shepherd Individual Corporate Director Apr 2, 2007
Cheri Padulese Individual Corporate Director Mar 24, 2023
W-2 Managing Employee Mar 24, 2023
Jillian Hudspeth Individual Corporate OfficerChief Executive Officer Jun 1, 2022
Jayashree Raman Individual Corporate Director Oct 1, 2020
Brett Waters Individual Corporate Director Oct 1, 2020

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776038400000",
    "number": "1508035064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 FEDERAL ST",
            "address_2": "SUITE 300",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031539",
            "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": "121 WHITE HORSE PIKE",
            "city": "CLEMENTON",
            "state": "NJ",
            "postal_code": "080214158",
            "telephone_number": "856-541-5933",
            "fax_number": "856-541-3340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMCARE HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-28",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "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"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NJ",
            "license": "70471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0133752",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clementon, NJ

Sources for this page

Verify at the official NPI Registry.