Active NPI
Mary Jean King
- Case Manager/Care Coordinator
- Philadelphia, PA
National Provider Identifier
1063541191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 3600 Market St Ste 601
Philadelphia, PA 19104 - Phone
- (267) 940-5512
- NPI assigned
- Mar 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
3600 Market St Ste 601
Philadelphia, PA 19104
Mailing address
1218 Arch St FL 6
Philadelphia, PA 19107-2816
Other practice location 1
600 N Olive St
Media, PA 19063-2418
Phone (610) 566-7540 ext. 242
Other practice location 2
600 N Olive St
Media, PA 19063-2418
Phone (610) 566-7540 ext. 242
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01840022 | Medicaid | PA |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Actionaids, Inc. | Social Worker | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548115200000",
"number": "1063541191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1218 ARCH ST FL 6",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191072816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 MARKET ST STE 601",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104",
"telephone_number": "267-940-5512"
}
],
"practiceLocations": [
{
"address_1": "600 N Olive St",
"address_purpose": "LOCATION",
"city": "Media",
"state": "PA",
"postal_code": "190632418",
"country_code": "US",
"telephone_number": "610-566-7540 x242",
"fax_number": "610-566-7677",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "600 N Olive St",
"address_purpose": "LOCATION",
"city": "Media",
"state": "PA",
"postal_code": "190632418",
"country_code": "US",
"telephone_number": "610-566-7540 x242",
"fax_number": "610-566-7677",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KING",
"first_name": "MARY JEAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-05",
"last_updated": "2019-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01840022",
"state": "PA"
}
],
"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 Jan 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.