Individual provider Active NPI

Fatmata Raymond, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Burlington, NJ
National Provider Identifier
1629353404
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ01344100 Issued in NJ
Practice address
98 Jennifer LN
Burlington, NJ 08016-1142
Phone
(571) 277-6003
NPI assigned
Oct 12, 2011
Last updated
Jul 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ01344100 NJ Primary
Registered Nurse 163W00000X 26NR15442100 NJ

Addresses

Primary practice location

98 Jennifer LN
Burlington, NJ 08016-1142

Mailing address

98 Jennifer LN
Burlington, NJ 08016-1142
Phone (571) 277-6003

Other practice location 1

1749 Hooper Ave Ste 202
Toms River, NJ 08753-8130
Phone (732) 930-1020

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
I20240409004192 NJ Practitioner - Nurse Practitioner 4183062110 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vimax LLCGroup PAC ID 7416273644, 21 clinicians

Practice addresses (Care Compare)

1749 Hooper Ave
Suite 202
Toms River, NJ 08753-8130
Phone (732) 930-1020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NR15442100NJMDRegistered Nurse
26NJ01344100NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mommy and Me Home Care of South Jersey LLC Current Accepting new patients
Vimax LLC CurrentSince Apr 16, 2024 Accepting new patients
Vimax LLC CurrentSince Apr 16, 2024 Accepting new patients
Grow Healthcare Group of New Jersey PC Psychiatric/Mental Health CurrentSince Jun 17, 2024 Accepting new patients
Vimax LLC Current Accepting new patients
Divine Oasis Home Health Services LLC Current Accepting new patients
Divine Oasis Home Health Services LLC Current Accepting new patients

Locations

6 Cornwall Ct
Ste B
East Brunswick, NJ 08816
Phone (732) 955-4141

221 River St
Ste 9
Hoboken, NJ 07030
Phone (201) 439-8902

1749 Hooper Ave
Ste 202
Toms River, NJ 08753
Phone (732) 930-1020

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1629353404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 JENNIFER LN",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "080161142",
            "telephone_number": "571-277-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 JENNIFER LN",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "080161142",
            "telephone_number": "571-277-6003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1749 Hooper Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Toms River",
            "state": "NJ",
            "postal_code": "087538130",
            "country_code": "US",
            "telephone_number": "732-930-1020",
            "fax_number": "732-395-2424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAYMOND",
        "first_name": "FATMATA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-12",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01344100",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR15442100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NJ

Sources for this page

Verify at the official NPI Registry.