NPIMap

Organization Active NPI

Greater Philadelphia Health Action Inc.

Doing business as GPHA South Philadelphia Health Ctr.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
National Provider Identifier
1023485265
Registry record updated Mar 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GREATER PHILADELPHIA HEALTH ACTION INC.
Doing business as
GPHA South Philadelphia Health Ctr.
Practice address
1408 S. Broad St.
2ND Floor
Philadelphia, PA 19146-4808
Phone
(215) 755-0700
Fax
(215) 755-6474
NPI assigned
Aug 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2017

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

Authorized official

Name
D Tina Smith
Title
Provider Enrollment Spec.
Phone
(215) 925-2400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1408 S. Broad St.
2ND Floor
Philadelphia, PA 19146-4808

Mailing address

1401 S. 31St Street
2ND Floor
Philadelphia, PA 19146-3506
Phone (215) 925-2400

Other names 1

  • GPHA South Philadelphia Health Ctr. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023485265. Details of each certification follow.

  • CCN 391031 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 391031

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
URBAN HEALTH INITIATIVES, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 3, 2012
Last certification
Aug 3, 2012
Ownership / control type
For profit – corporation
Facility address
1408 South Broad Street
Phila, PA 19146

National Provider Directory

National Provider Directory

Locations

1408 S Broad St
Fl 2
Philadelphia, PA 19146
Phone (215) 467-3515

NPI Registry JSON

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489536000000",
    "number": "1023485265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S. 31ST STREET",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191463506",
            "telephone_number": "215-925-2400",
            "fax_number": "215-925-9162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 S. BROAD ST.",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191464808",
            "telephone_number": "215-755-0700",
            "fax_number": "215-755-6474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER PHILADELPHIA HEALTH ACTION INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-24",
        "last_updated": "2017-03-15",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "D",
        "authorized_official_middle_name": "TINA",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT SPEC.",
        "authorized_official_telephone_number": "215-925-2400"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GPHA South Philadelphia Health Ctr.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.