NPIMap

Organization Active NPI

Delaware Valley Community Health, Inc.

Doing business as Fairmount Primary Care Center at Girard Medical Center

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
National Provider Identifier
1538619333
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
DELAWARE VALLEY COMMUNITY HEALTH, INC.
Doing business as
Fairmount Primary Care Center at Girard Medical Center
Practice address
820 W. Thompson Street
Philadelphia, PA 19122-4212
Phone
(215) 827-8010
Fax
(215) 232-1037
NPI assigned
Oct 5, 2016
Last updated
Feb 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Authorized official

Name
Ms. Brenda Robles Cooke
Title
President & Ceo
Phone
(215) 684-5344

Specialties & licenses 1

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

Addresses

Primary practice location

820 W. Thompson Street
Philadelphia, PA 19122-4212

Mailing address

1412-22 Fairmount Avenue
Philadelphia, PA 19130-2908
Phone (215) 684-5344

Other identifiers 1

IdentifierTypeStateIssuer
1007729960028MedicaidPA

Other names 1

  • Fairmount Primary Care Center at Girard Medical Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dvchngrts.dvchngrts.p1@direct.dvch.nextgenshare.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161114000073 PA Part A Provider - Federally Qualified Health Center (FQHC) 8426967175 Practice locations: Philadelphia, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1538619333. Details of each certification follow.

Federally qualified health center certification: CCN 391081

Legal name
DELAWARE VALLEY COMMUNITY HEALTH, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 17, 2016
Last certification
Oct 17, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 30, 1977 in PA
Enrollment address
820 W Thompson Street
Philadelphia, PA 19122-4212

Other NPIs with the same Medicare PAC ID 10

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2121951Fairmount Primary Care Center at Girard Med Ctr820 W Thompson Street, Philadelphia, PA 19122Provider-performed microscopyJan 29, 2028

National Provider Directory

National Provider Directory
Tax ID family
Delaware Valley Communi12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

1412 Fairmount Ave
Fl Second
Philadelphia, PA 19130

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Alvan Scott McNeal Individual Corporate OfficerPresident & Ceo Jan 1, 2019
W-2 Managing EmployeePresident & Ceo Oct 11, 1993
Carla M Wimbush Individual Corporate OfficerSr. VP, Cfo, Board Member Aug 7, 1995
W-2 Managing EmployeeSr. Vice President & Cfo Aug 7, 1995
Operational/Managerial Control Aug 7, 1995

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Norristown Regional Health CenterNorristown, PA, CCN 391901 Federally qualified health center Operational/Managerial Control Oct 1, 1999
Delaware Valley Community Health, Inc.Philadelphia, PA, CCN 391113 Federally qualified health center Operational/Managerial Control Aug 30, 1977

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 11

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": "1475625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770681600000",
    "number": "1538619333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412-22 FAIRMOUNT AVENUE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191302908",
            "telephone_number": "215-684-5344",
            "fax_number": "215-232-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 W. THOMPSON STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191224212",
            "telephone_number": "215-827-8010",
            "fax_number": "215-232-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAWARE VALLEY COMMUNITY HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-05",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A",
        "authorized_official_last_name": "ROBLES COOKE",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "215-684-5344",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007729960028",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dvchngrts.dvchngrts.p1@direct.dvch.nextgenshare.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "820 W. Thompson Street",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191224212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Fairmount Primary Care Center at Girard Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fairmount Primary Care Center at Girard Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.