NPIMap

Organization Active NPI

Project H.O.P.E., Inc.

  • Federally Qualified Health Center (FQHC)
  • Camden, NJ
National Provider Identifier
1891969218
Registry record updated Sep 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PROJECT H.O.P.E., INC.
Practice address
519-525 West St
Camden, NJ 08103-3529
Phone
(856) 968-2320
Fax
(856) 968-2317
NPI assigned
Apr 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2016

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

Authorized official

Name
Mrs. Patricia Deshields, MSW, LSW, RN
Title
Ceo
Phone
(856) 541-6092

Specialties & licenses 1

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

Addresses

Primary practice location

519-525 West St
Camden, NJ 08103-3529

Mailing address

519-525 West St
Camden, NJ 08103-3529
Phone (856) 968-2320

Other identifiers 1

IdentifierTypeStateIssuer
0470121MedicaidNJ

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081224000337 NJ Part A Provider - Federally Qualified Health Center (FQHC) 3779645866 Practice locations: Camden, NJ
O20140827000504 NJ Part B Supplier - Clinic/Group Practice 3779645866 Receives reassigned benefits from 7 practitioners
Practice locations: Camden, NJ

Federally qualified health center certification: CCN 311890

Legal name
PROJECT H.O.P.E., INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 12, 2009
Last certification
Feb 12, 2009
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Enrollment address
519-525 West Street
Camden, NJ 81033529

National Provider Directory

National Provider Directory

Locations

439 Clinton St
Camden, NJ 08103
Phone (856) 757-3865

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Geraldine Martinez Individual Corporate DirectorCeo Oct 1, 2023
W-2 Managing Employee Oct 1, 2023
Yahaira Mercado Individual W-2 Managing EmployeeSenior Medical Billing Specialist Mar 1, 2023
Carl Boyd Individual Corporate OfficerBoard President Jun 1, 2024
Keith Stewart Individual Corporate OfficerBoard Officer Jul 1, 2022
Paul Foster Individual Corporate OfficerBoard Vice President Oct 1, 2024

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473897600000",
    "number": "1891969218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519-525 WEST ST",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081033529",
            "telephone_number": "856-968-2320",
            "fax_number": "856-968-2317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519-525 WEST ST",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081033529",
            "telephone_number": "856-968-2320",
            "fax_number": "856-968-2317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROJECT H.O.P.E., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-16",
        "last_updated": "2016-09-15",
        "status": "A",
        "authorized_official_last_name": "DESHIELDS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "856-541-6092",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW, LSW, RN"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0470121",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.