Active NPI
Angela Jane Pavilion Acute Rehabilitation Hospital
- Rehabilitation Hospital
- Philadelphia, PA
National Provider Identifier
1568667137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Hospital
- License
- 12800101
- Legal business name
- ANGELA JANE PAVILION ACUTE REHABILITATION HOSPITAL
- Practice address
- 8410 Roosevelt Blvd
Philadelphia, PA 19152-2012 - Phone
- (215) 708-1200
- Fax
- (215) 708-2967
- NPI assigned
- Jun 15, 2007
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Rose Marie Catherine Valentine, ADMINISTRATOR
- Title
- Ceo
- Phone
- (215) 708-1200
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Hospital | 283X00000X | 12800101 | PA | Primary |
Addresses
Primary practice location
8410 Roosevelt Blvd
Philadelphia, PA 19152-2012
Mailing address
8410 Roosevelt Blvd
Philadelphia, PA 19152-2012
Phone (215) 708-1200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1568667137. Details of each certification follow.
Hospital certification: CCN 393051
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- ANGELA JANE PAVILION REHABILITATION HOSPITAL
- Certification status
- Terminated Voluntary: merger or closure, Jun 30, 2010
- Provider type (POS)
- Hospital – Rehabilitation
- Participating since
- Feb 10, 2003
- Last certification
- Feb 11, 2003
- Beds
- 17
- Ownership / control type
- Private (for profit)
- Facility address
- 8410 Roosevelt Boulevard
Philadelphia, PA 19152
National Provider Directory
National Provider Directory- Tax ID family
- Ajp
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Inpatient Hospice
- Philadelphia, PA
- NPI 1740670058
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181865600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1568667137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8410 ROOSEVELT BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191522012",
"telephone_number": "215-708-1200",
"fax_number": "215-708-2967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8410 ROOSEVELT BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191522012",
"telephone_number": "215-708-1200",
"fax_number": "215-708-2967"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ANGELA JANE PAVILION ACUTE REHABILITATION HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2007-06-15",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "VALENTINE",
"authorized_official_first_name": "ROSE MARIE",
"authorized_official_middle_name": "CATHERINE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "215-708-1200",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "ADMINISTRATOR"
},
"taxonomies": [
{
"code": "283X00000X",
"taxonomy_group": "",
"desc": "Rehabilitation Hospital",
"state": "PA",
"license": "12800101",
"primary": true
}
],
"identifiers": [],
"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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.