Active NPI
Hall-Mercer CMH-MRC of PA
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Phila, PA
National Provider Identifier
1558414847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Legal business name
- HALL-MERCER CMH-MRC OF PA
- Practice address
- 245 S 8TH St
Phila, PA 19106-3520 - Phone
- (215) 796-4640
- Fax
- (609) 770-7792
- NPI assigned
- Jan 19, 2007
- Last updated
- Mar 30, 2023
- Organization subpart
- Yes
- Parent organization
- PENNSYLVANIA HOSPITAL OF THE HOSPITAL OF THE UNIV OF PA HEALTH SYSTEM
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Thomas McCormick
- Title
- Assistant Vice President
- Phone
- (215) 796-4640
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Primary |
Addresses
Primary practice location
245 S 8TH St
Phila, PA 19106-3520
Mailing address
1500 Market St
Um600
Phila, PA 19102-2100
Phone (215) 796-4640
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000049150027 | Medicaid | PA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
- Hall-Mercer CMH-MRC of Pennsylvania Hosp
- Part of
- Hall-Mercer CMH-MRC of Pennsylvania Hosp
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1680134400000",
"number": "1558414847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 MARKET ST",
"address_2": "UM600",
"city": "PHILA",
"state": "PA",
"postal_code": "191022100",
"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": "PHILA",
"state": "PA",
"postal_code": "191063520",
"telephone_number": "215-796-4640",
"fax_number": "609-770-7792"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HALL-MERCER CMH-MRC OF PA",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PENNSYLVANIA HOSPITAL OF THE HOSPITAL OF THE UNIV OF PA HEALTH SYSTEM",
"enumeration_date": "2007-01-19",
"last_updated": "2023-03-30",
"certification_date": "2023-03-30",
"status": "A",
"authorized_official_last_name": "MCCORMICK",
"authorized_official_first_name": "THOMAS",
"authorized_official_title_or_position": "ASSISTANT VICE PRESIDENT",
"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
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1000049150027",
"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 Phila, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.