Individual provider Active NPI

Jenna Marie Rudd, CRNP

  • Women's Health Nurse Practitioner
  • Voorhees, NJ
National Provider Identifier
1982212957
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
SP022153 Issued in PA
Practice address
1307 White Horse Rd Ste A100
Voorhees, NJ 08043-2100
Phone
(856) 424-8091
NPI assigned
Jul 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X SP022153 PA Primary
Women's Health Nurse Practitioner 363LW0102X 26NJ14981800 NJ

Addresses

Primary practice location

1307 White Horse Rd Ste A100
Voorhees, NJ 08043-2100

Mailing address

401 Route 73 N Ste 320
Marlton, NJ 08053-3426
Phone (856) 872-7055

Other practice location 1

925 Chestnut St Ste 320A
Philadelphia, PA 19107-4216
Phone (215) 955-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20201026003015 PA Practitioner - Nurse Practitioner 0042630303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Jefferson Medical College of Thomas Jefferson University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

833 Chestnut St
Suite 1
Philadelphia, PA 19107-4420
Phone (215) 955-5000

Hospital & facility affiliations

  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ14981800NJMDWomen's Health Nurse Practitioner
SP022153PAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince Sep 1, 2020 Accepting new patients
Jefferson University Physicians Past Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

925 Chestnut St
Ste 320A
Philadelphia, PA 19107
Phone (215) 955-1175

833 Chestnut St
Fl 1
Philadelphia, PA 19107
Phone (215) 955-1085

1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836

1101 Chestnut St
Fl 12
Philadelphia, PA 19107

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1982212957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ROUTE 73 N STE 320",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533426",
            "telephone_number": "856-872-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 WHITE HORSE RD STE A100",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080432100",
            "telephone_number": "856-424-8091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 Chestnut St Ste 320A",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074216",
            "country_code": "US",
            "telephone_number": "215-955-6200",
            "fax_number": "215-955-1620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUDD",
        "first_name": "JENNA",
        "middle_name": "MARIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "PA",
            "license": "SP022153",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NJ",
            "license": "26NJ14981800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.