NPIMap

Organization Active NPI

Intercommunity Action, Inc

  • Case Management Agency
  • Phila, PA
National Provider Identifier
1508901125
Registry record updated Mar 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
INTERCOMMUNITY ACTION, INC
Practice address
6122 Ridge Ave
Phila, PA 19128-1603
Phone
(215) 509-1900
NPI assigned
Feb 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2009

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

Authorized official

Name
David Bolin
Title
Executive Director
Phone
(215) 487-0906

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

6122 Ridge Ave
Phila, PA 19128-1603

Mailing address

6012 Ridge Ave
Phila, PA 19128-1643

Other identifiers 1

IdentifierTypeStateIssuer
1000008360077MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Intercommunity Action Inc25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236643200000",
    "number": "1508901125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6012 RIDGE AVE",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191281643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6122 RIDGE AVE",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191281603",
            "telephone_number": "215-509-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERCOMMUNITY ACTION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2009-03-10",
        "status": "A",
        "authorized_official_last_name": "BOLIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "215-487-0906"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000008360077",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phila, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2009; 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.