The Wedge Medical Center, P.C.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

THE WEDGE MEDICAL CENTER, P.C.

Doing business as

Wedge Recovery Centers

Practice address

5520 Chester Ave
Philadelphia, PA 19143-5328

Phone

(215) 276-3922

NPI assigned

Dec 5, 2022

Organization subpart

Yes

Parent organization

THE WEDGE MEDICAL CENTER, INCAs reported in NPPES

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

Authorized official

Name

Takisa S Gallman

Title

VP Administrative Services

Phone

(215) 276-3922

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wedge Recovery Centers Doing business as

Tax ID family

Wedge Medical Center PC5 organizations share this tax ID, including this one

Part of

Wedge Medical Center PC

Other organizations with this tax ID 4

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

• The Wedge Medical Center, P.C.

  • Professional Counselor
  • Philadelphia, PA
  • NPI 1053538447
  NPD tax ID
• The Wedge Medical Center, P.C.

  • Addiction (Substance Use Disorder) Counselor
  • Philadelphia, PA
  • NPI 1508806886
  NPD tax ID
• The Wedge Medical Center, P.C.

  • Professional Counselor
  • Philadelphia, PA
  • NPI 1730306291
  NPD tax ID
• Wedge Medical Center, PC

  • Addiction (Substance Use Disorder) Counselor
  • Philadelphia, PA
  • NPI 1215176342
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Wedge Medical Center, PC

  • Addiction (Substance Use Disorder) Counselor
  • Philadelphia, PA
  • NPI 1215176342
  NPPES parent name

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670198400000",
    "number": "1396455945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6711 OLD YORK RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191262841",
            "telephone_number": "215-276-3922",
            "fax_number": "215-276-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 CHESTER AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191435328",
            "telephone_number": "215-276-3922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WEDGE MEDICAL CENTER, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE WEDGE MEDICAL CENTER, INC",
        "enumeration_date": "2022-12-05",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A",
        "authorized_official_last_name": "GALLMAN",
        "authorized_official_first_name": "TAKISA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "VP ADMINISTRATIVE SERVICES",
        "authorized_official_telephone_number": "215-276-3922"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100728192",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wedge Recovery Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The Visiting Nurse Association of Greater Philadelphia (Hospice of Philadelphia)
• The Visiting Nurse Association of Greater Philadelphia (Hospice of Philadelphia)
• The Visiting Nurse Association of Greater Philadelphia
• The Walter D. Palmer Leadership Learning Partners Charter School
• The Wedge Medical Center, P.C.
• The Wedge Medical Center, P.C.
• The Wedge Medical Center, P.C.
• Linda Thea
• Simon Daniel Xavier Thebault, M.D.
• Elizabeth Anne Theis, PA-C

• Community/Behavioral Health Agency in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Community/Behavioral Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.