NPIMap

Organization Active NPI

Hall-Mercer CMH-MRC of Pennsylvania Hosp

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Philadelphia, PA
National Provider Identifier
1407909088
Registry record updated Feb 9, 2024
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 PENNSYLVANIA HOSP
Practice address
245 S 8TH St
Philadelphia, PA 19106-3520
Phone
(215) 796-4640
Fax
(609) 770-7792
NPI assigned
Jan 18, 2007
Organization subpart
Yes
Parent organization
PENNSYLVANIA HOSPITAL OF THE UNIV OF PA HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Authorized official

Name
Mr. Thomas McCormick
Title
Managing Director
Phone
(215) 796-4640

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

245 S 8TH St
Philadelphia, PA 19106-3520

Mailing address

245 S 8TH St
Phila, PA 19106-3520
Phone (215) 796-4640

Other identifiers 1

IdentifierTypeStateIssuer
1000049150013MedicaidPA

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
The Pennsylvanis Hospital14 organizations share this tax ID, including this one
Part of
The Pennsylvanis Hospital

Other organizations with this tax ID 13

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

View all 13

Locations

1500 Market St
Ste UM600
Philadelphia, PA 19102

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707436800000",
    "number": "1407909088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 S 8TH ST",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191063520",
            "telephone_number": "215-796-4640",
            "fax_number": "609-770-7792"
        },
        {
            "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": "215-796-4640",
            "fax_number": "609-770-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALL-MERCER CMH-MRC OF PENNSYLVANIA HOSP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENNSYLVANIA HOSPITAL OF THE UNIV OF PA HEALTH SYSTEM",
        "enumeration_date": "2007-01-18",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "215-796-4640",
        "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
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000049150013",
            "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 Feb 9, 2024; 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.