NPIMap

Organization Active NPI

West Philadelphia Community MH Consortium Inc.

Doing business as The Consortium Inc.

  • Forensic Psychiatry Physician
  • Philadelphia, PA
National Provider Identifier
1588786487
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic Psychiatry PhysicianTaxonomy code 2084F0202X
License
1007155230075 Issued in PA
Legal business name
WEST PHILADELPHIA COMMUNITY MH CONSORTIUM INC.
Doing business as
The Consortium Inc.
Practice address
1801 Vine St
Philadelphia, PA 19103-1117
Phone
(215) 596-8100
Fax
(215) 382-4405
NPI assigned
Apr 4, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. John F. White Jr.
Title
President Ceo
Phone
(215) 596-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X 1007155230075 PA Primary

Addresses

Primary practice location

1801 Vine St
Philadelphia, PA 19103-1117

Mailing address

3801 Market St
Suite 201
Philadelphia, PA 19104-3153
Phone (215) 596-8100

Other identifiers 1

IdentifierTypeStateIssuer
1007155230075MedicaidPA

Other names 1

  • The Consortium Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
The Consortium Inc35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1588786487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 MARKET ST",
            "address_2": "SUITE 201",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043153",
            "telephone_number": "215-596-8100",
            "fax_number": "215-382-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 VINE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191031117",
            "telephone_number": "215-596-8100",
            "fax_number": "215-382-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST PHILADELPHIA COMMUNITY MH CONSORTIUM INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT  CEO",
        "authorized_official_telephone_number": "215-596-8100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "PA",
            "license": "1007155230075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007155230075",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Consortium Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.