NPIMap

Organization Active NPI

United Cerebral Palsy Assn of Philadelphia & Vicinity

  • Home Health Agency
  • Philadelphia, PA
National Provider Identifier
1255548582
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
171040 Issued in PA
Legal business name
UNITED CEREBRAL PALSY ASSN OF PHILADELPHIA & VICINITY
Practice address
102 E Mermaid LN
Philadelphia, PA 19118-3507
Phone
(215) 242-4200
Fax
(215) 247-4229
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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

Authorized official

Name
Mr. Willis A Dibble
Title
Executive Director
Phone
(215) 248-7602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 171040 PA Primary

Addresses

Primary practice location

102 E Mermaid LN
Philadelphia, PA 19118-3507

Mailing address

102 E Mermaid LN
Philadelphia, PA 19118-3507
Phone (215) 242-4200

Other identifiers 1

IdentifierTypeStateIssuer
100001510 0014MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Ucp of Philadelphia3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1255548582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 E MERMAID LN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191183507",
            "telephone_number": "215-242-4200",
            "fax_number": "215-247-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E MERMAID LN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191183507",
            "telephone_number": "215-242-4200",
            "fax_number": "215-247-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED CEREBRAL PALSY ASSN OF PHILADELPHIA & VICINITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "DIBBLE",
        "authorized_official_first_name": "WILLIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "215-248-7602",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": "171040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100001510 0014",
            "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 Jul 14, 2008; 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.