NPIMap

Organization Active NPI

Hall- Mercer CMH-MRC of PA Hosp

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Philadelphia, PA
National Provider Identifier
1306997655
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
HALL- MERCER CMH-MRC OF PA HOSP
Practice address
245 S 8TH St
Philadelphia, PA 19106-3520
Phone
(215) 349-5150
Fax
(215) 615-0432
NPI assigned
Jan 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Authorized official

Name
Mr. Thomas McCormick
Title
Assistance Vice President
Phone
(215) 662-2709

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

245 S 8TH St
Philadelphia, PA 19106-3520

Mailing address

245 S 8TH St
Philadelphia, PA 19106-3520
Phone (215) 349-5150

Other identifiers 1

IdentifierTypeStateIssuer
1000049150025MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

National Provider Directory

National Provider Directory
Tax ID family
Pennsylvania Hospital of the University of Pennsylvania Health System14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1306997655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 S 8TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063520",
            "telephone_number": "215-349-5150",
            "fax_number": "215-615-0432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 S 8TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063520",
            "telephone_number": "215-349-5150",
            "fax_number": "215-615-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALL- MERCER CMH-MRC OF PA HOSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-15",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "ASSISTANCE VICE PRESIDENT",
        "authorized_official_telephone_number": "215-662-2709",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000049150025",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Mar 30, 2023; 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.