Individual provider Active NPI

Rachel F Ennis, CRNP

  • Primary Care Nurse Practitioner
  • JB MDL, NJ
National Provider Identifier
1689012437
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
26NJ01414400 Issued in NJ
Practice address
3458 Neely Rd
JB MDL, NJ 08641-5312
Phone
(866) 377-2778
Fax
(609) 754-9249
NPI assigned
Jun 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 26NJ01414400 NJ Primary

Addresses

Primary practice location

3458 Neely Rd
JB MDL, NJ 08641-5312

Mailing address

3458 Neely Rd
JB MDL, NJ 08641-5312
Phone (866) 377-2778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200910002024 PA Practitioner - Nurse Practitioner 7113345919 Reassigns benefits to 1 organization
I20230215001803 NJ Practitioner - Nurse Practitioner 7113345919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.41 of 100Reported as group
Quality
77.71
Improvement activities
40
Cost
82.25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01414400NJMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates of New Jersey, LLC CurrentSince Jan 10, 2025 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jun 1, 2025 Accepting new patients

Locations

116 Village Blvd
Ste 200
Princeton, NJ 08540
Phone (609) 285-3094

600 N 2nd St
Ste 401
Harrisburg, PA 17101
Phone (844) 341-2339

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 2

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": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1689012437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3458 NEELY RD",
            "city": "JB MDL",
            "state": "NJ",
            "postal_code": "086415312",
            "telephone_number": "866-377-2778",
            "fax_number": "609-754-9249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3458 NEELY RD",
            "city": "JB MDL",
            "state": "NJ",
            "postal_code": "086415312",
            "telephone_number": "866-377-2778",
            "fax_number": "609-754-9249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "RACHEL",
        "middle_name": "F",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-13",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ01414400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in JB MDL, NJ

Sources for this page

Verify at the official NPI Registry.