Healthmark, Incorporated

Primary specialty

Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X

License

MD058825L Issued in PA

Legal business name

HEALTHMARK, INCORPORATED

Practice address

1 Crescent Dr.
Navy Yard Suite 100
Philadelphia, PA 19112

Phone

(215) 952-9900

Fax

(215) 952-9977

NPI assigned

Mar 19, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Diane Wildermuth, R.N.

Title

Director

Phone

(215) 952-9900

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023132867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1CRESCENT DR.",
            "address_2": "NAVY YARD SUITE 100",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19112",
            "telephone_number": "215-952-9900",
            "fax_number": "215-952-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CRESCENT DR.",
            "address_2": "NAVY YARD SUITE 100",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19112",
            "telephone_number": "215-952-9900",
            "fax_number": "215-952-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHMARK, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILDERMUTH",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "215-952-9900",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "PA",
            "license": "MD058825L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT",
            "identifier": "72118",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Occupational Medicine Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Occupational Medicine Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.