Organization Active NPI

Urban Health Initiatives, Inc.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1497058390
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
URBAN HEALTH INITIATIVES, INC.
Practice address
1408 S. Broad Street
Philadelphia, PA 19146-4808
Phone
(215) 755-0700
NPI assigned
Dec 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

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

Authorized official

Name
Mr. Kobie West
Title
Ceo
Phone
(215) 755-0700

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

1408 S. Broad Street
Philadelphia, PA 19146-4808

Mailing address

1408 S Broad St
Philadelphia, PA 19146-4808

Other identifiers 1

IdentifierTypeStateIssuer
0006915720002MedicaidPA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292371200000",
    "number": "1497058390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191464808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 S. BROAD STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191464808",
            "telephone_number": "215-755-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URBAN HEALTH INITIATIVES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-15",
        "last_updated": "2010-12-15",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "KOBIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "215-755-0700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006915720002",
            "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 Dec 15, 2010; 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.