Active NPI
Martina Mobley-Altice
- Community/Behavioral Health Agency
- Philadelphia, PA
National Provider Identifier
1053822643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Practice address
- 5650 Sprague St
Philadelphia, PA 19138-1744 - Phone
- (215) 951-5689
- NPI assigned
- Oct 23, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
5650 Sprague St
Philadelphia, PA 19138-1744
Mailing address
402 W Walnut LN Apt 3
Philadelphia, PA 19144-3750
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508716800000",
"number": "1053822643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 W WALNUT LN APT 3",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191443750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5650 SPRAGUE ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191381744",
"telephone_number": "215-951-5689"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOBLEY-ALTICE",
"first_name": "MARTINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-23",
"last_updated": "2017-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.