Davina Ann Soernssen, RN
Individual provider Active NPI Family Nurse Practitioner · Runnemede, NJ
NPI 1861941841 · NPPES record last updated Apr 16, 2020
Key facts
- NPI
- 1861941841
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 26NO11716700 (NJ)
- Practice address
- 20 S Black Horse Pike
Runnemede, NJ 08078-1901 - Phone
- (856) 962-8840
- NPI assigned
- Oct 1, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200317001660 | NJ | Practitioner - Nurse Practitioner | 1658709191 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26O11716700 | NJ | MD | Continuing Education/Staff Development Registered Nurse |
| 26NO11716700 | NJ | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Care, Inc. | Current |
Accepting new patients | |
| Act on Total Health Medical Group, LLC | Current |
Accepting new patients | |
| Community Health Care, Inc. | Current |
Accepting new patients | |
| Cooper Family Medicine, PC | Current |
Accepting new patients | |
| Cooper Family Medicine PC | Current |
Accepting new patients |
Locations
30 N Pearl St
Bridgeton, NJ 08302
1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920
401 Haddon Ave
Fl 2
Camden, NJ 08103
Phone (846) 342-2000
108 W Jimmie Leeds Rd
Galloway, NJ 08205
Phone (609) 553-1969
335 Delsea Dr N
Glassboro, NJ 08028
Phone (856) 863-5720
504 White Horse Pike
Haddon Hgts, NJ 08035
Phone (856) 546-7990
2354 US Highway 9
Howell, NJ 07731
Phone (732) 905-5255
1001 Lincoln Dr W
Ste F
Marlton, NJ 08053
Phone (609) 810-1800
530 High St N
Millville, NJ 08332
Phone (856) 506-8556
20 S Black Horse Pike
Runnemede, NJ 08078
Phone (856) 536-1650
Interoperability endpoints
- davina.soernssen.p1@direct.cchn.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Continuing Education/Staff Development Registered Nurse | 163WC1600X | 26O11716700 | NJ | |
| Family Nurse Practitioner | 363LF0000X | 26NO11716700 | NJ | Yes |
Addresses
Primary practice location
20 S Black Horse Pike
Runnemede, NJ 08078-1901
Mailing address
1 Federal St Ste Sw200
Camden, NJ 08103-1155
Phone (856) 356-4924
Other providers in Runnemede, NJ
- Moira Schwager
- Pallav Shah
- David E. Sharon
- Jamie Sharon
- Dongjin Shin
- The Optical Shoppe Inc.
- Andrea Lynn Tilton
- Vianca S Vargas
- Elizabeth Walker
- Jordynbrielle Elaine Wallace
All providers in Runnemede, NJ · Family Nurse Practitioner in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.