NPIMap

Organization Active NPI

Greater Philadelphia Health Action Inc.

Doing business as GPHA- Spectrum Behavioral Srvs.

  • Federally Qualified Health Center (FQHC)
  • Springfield, PA
National Provider Identifier
1467976001
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GREATER PHILADELPHIA HEALTH ACTION INC.
Doing business as
GPHA- Spectrum Behavioral Srvs.
Practice address
1489 Baltimore Pike, Building 300, Suite 300
The Mills of Victoria
Springfield, PA 19064-6024
Phone
(484) 472-7430
Fax
(484) 472-7718
NPI assigned
Jul 26, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
D. Tina Smith
Title
Provider Enrollment Spec.
Phone
(215) 925-2400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

1489 Baltimore Pike, Building 300, Suite 300
The Mills of Victoria
Springfield, PA 19064-6024

Mailing address

1401 S 31St St FL 2
Philadelphia, PA 19146-3506
Phone (215) 925-2400

Other names 1

  • GPHA- Spectrum Behavioral Srvs. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110602000389 PA Part B Supplier - Clinic/Group Practice 9537064977 Receives reassigned benefits from 242 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Springfield, PA; Philadelphia, PA
O20170921003302 PA Part A Provider - Federally Qualified Health Center (FQHC) 9537064977 Practice locations: Springfield, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467976001. Details of each certification follow.

Federally qualified health center certification: CCN 391098

Legal name
GREATER PHILADELPHIA HEALTH ACTION INC
Doing business as
GPHA - SPECTRUM BEHAVIORAL SERVICES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 19, 2017
Last certification
Sep 19, 2017
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Jul 20, 1970 in PA
Enrollment address
1489 Baltimore Pike
The Mills of Victoria Building 300 Suite 300
Springfield, PA 19064-3958

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Gpha Midwifery Services39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

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

View all 38

Locations

5000 Woodland Ave
Philadelphia, PA 19143
Phone (215) 726-9807

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Claire a Washington Individual Corporate OfficerBoard Member Mar 1, 2001
Celeste Johns Individual Corporate DirectorReimbursement Director Jun 23, 2008
Janice a Smith Individual Corporate OfficerBoard Member Mar 1, 1979
Ashley a Hines Individual Corporate OfficerBoard Member Oct 1, 2006
Valerie E Tuck Individual Corporate OfficerBoard Member Mar 1, 2015
Roger C Collins Individual Corporate OfficerBoard Member Assistant Treasurer Mar 1, 1979
Stephen R Cox Individual Corporate OfficerBoard Member Second Vice Chairpe Mar 1, 2000
Royal E Brown Individual Corporate OfficerBoard Member Chairperson Mar 1, 1988
Brian Clark Individual Corporate OfficerCeo/Executive Director Jan 1, 2018
Corporate DirectorCeo/Executive Director Jan 1, 2018
W-2 Managing EmployeeCeo/Executive Director Jan 1, 2018
Sandra Hawkins-Dorsey Individual Corporate OfficerBoard Member Mar 1, 2004
Flora M Castillo Individual Corporate OfficerBoard Member Mar 1, 2008
Linda W Powell Individual Corporate OfficerBoard Member First Vicepresident Mar 1, 2004
Phyllis H Detwiler Individual Corporate OfficerBoard Member Mar 1, 2012
Paula D Jackson Individual Corporate OfficerBoard Member Corporate Secretary Mar 1, 1993

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1467976001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S 31ST ST FL 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191463506",
            "telephone_number": "215-925-2400",
            "fax_number": "215-925-9162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1489 BALTIMORE PIKE, BUILDING 300, SUITE 300",
            "address_2": "THE MILLS OF VICTORIA",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190646024",
            "telephone_number": "484-472-7430",
            "fax_number": "484-472-7718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER PHILADELPHIA HEALTH ACTION INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "D.",
        "authorized_official_middle_name": "TINA",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT SPEC.",
        "authorized_official_telephone_number": "215-925-2400"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GPHA- Spectrum Behavioral Srvs.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GPHA- Spectrum Behavioral Srvs.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, PA

Sources for this page

Verify at the official NPI Registry.