NPIMap

Organization Active NPI

The Osborn Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Camden, NJ
National Provider Identifier
1730695305
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
24959 Issued in NJ
Legal business name
THE OSBORN FAMILY HEALTH CENTER, INC.
Practice address
1601 Haddon Ave
Camden, NJ 08103-3109
Phone
(856) 365-7726
Fax
(856) 757-3946
NPI assigned
Dec 19, 2017
Last updated
Oct 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Authorized official

Name
Sabrina E Cannady
Title
Chief Operating Officer
Phone
(856) 757-3700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 24959 NJ Primary

Addresses

Primary practice location

1601 Haddon Ave
Camden, NJ 08103-3109

Mailing address

1601 Haddon Ave
Camden, NJ 08103-3109
Phone (856) 365-7726

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20151112000931 NJ Part B Supplier - Clinic/Group Practice 1658681184 Receives reassigned benefits from 37 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Camden, NJ
O20180320000149 NJ Part A Provider - Federally Qualified Health Center (FQHC) 1658681184 Practice locations: Camden, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730695305. Details of each certification follow.

Federally qualified health center certification: CCN 311939

Legal name
THE OSBORN FAMILY HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 20, 2018
Last certification
Mar 20, 2018
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Jul 1, 2015 in NJ
Enrollment address
1601 Haddon Ave
Camden, NJ 81033109

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
The Osborn Fam HLTH Ctr Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1601 Haddon Ave
Camden, NJ 08103
Phone (856) 757-3700

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Sabrina Cannady Individual W-2 Managing EmployeePresident/Ceo Dec 1, 2017

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 34

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 34

NPI Registry JSON

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1730695305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 HADDON AVE",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081033109",
            "telephone_number": "856-365-7726",
            "fax_number": "856-757-3946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 HADDON AVE",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081033109",
            "telephone_number": "856-365-7726",
            "fax_number": "856-757-3946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE OSBORN FAMILY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-19",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A",
        "authorized_official_last_name": "CANNADY",
        "authorized_official_first_name": "SABRINA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "856-757-3700"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NJ",
            "license": "24959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.