Individual provider Active NPI

Randi Rosen-Kamen, CPNP

  • Pediatric Nurse Practitioner
  • Willingboro, NJ
National Provider Identifier
1760717110
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
26NN07680500 Issued in NJ
Practice address
621 Beverly Rancocas Rd
Willingboro, NJ 08046-3727
Phone
(609) 877-6800
NPI assigned
Oct 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X UP002041D PA
Pediatric Nurse Practitioner 363LP0200X 26NN07680500 NJ Primary

Addresses

Primary practice location

621 Beverly Rancocas Rd
Willingboro, NJ 08046-3727

Mailing address

1762 Garwood Dr
Cherry Hill, NJ 08003-3206
Phone (856) 616-1659

Other identifiers 1

IdentifierTypeStateIssuer
0287920MedicaidNJ

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
I20210915002973 NJ Practitioner - Nurse Practitioner 4981001070 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
UP002041DPAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Osborn Family Health Center, Inc. CurrentSince Jun 1, 2021 Accepting new patients
The Osborn Family Health Center, Inc. CurrentSince Jun 1, 2021 Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: rkamen@osbornfhc.directbygreenway.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72983

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": "1254441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1760717110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1762 GARWOOD DR",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080033206",
            "telephone_number": "856-616-1659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 BEVERLY RANCOCAS RD",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080463727",
            "telephone_number": "609-877-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN-KAMEN",
        "first_name": "RANDI",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-02",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "UP002041D",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NN07680500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0287920",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willingboro, NJ

Sources for this page

Verify at the official NPI Registry.