NPIMap

Organization Active NPI

St. Agnes Long Term Intensive Care, LLP

  • Long Term Care Hospital
  • Philadelphia, PA
National Provider Identifier
1609871318
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
License
97100101 Issued in PA
Legal business name
ST. AGNES LONG TERM INTENSIVE CARE, LLP
Practice address
1900 S Broad St
Philadelphia, PA 19145-2304
Phone
(215) 339-4100
Fax
(215) 339-0482
NPI assigned
Jun 17, 2005
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
Mrs. Teresa A. Gresko
Title
Chief Financial Officer, VP Finance
Phone
(215) 339-4223

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X 97100101 PA Primary

Addresses

Primary practice location

1900 S Broad St
Philadelphia, PA 19145-2304

Mailing address

1900 S Broad St
Philadelphia, PA 19145-2304
Phone (215) 339-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Hospital certification: CCN 390022

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
ST AGNES MEDICAL CENTER
Certification status
Terminated Voluntary: merger or closure, Jun 15, 2004
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 19, 2003
Beds
259 (222 certified)
Ownership / control type
Private (not for profit)
Most recent change of ownership
Jun 15, 2004 (2 total)
Facility address
1900 S Broad St
Philadelphia, PA 19145

Hospital certification: CCN 390308

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
ST AGNES LONG TERM CARE HOSPITAL
Certification status
Terminated Other: provider status change, Dec 31, 2004
Provider type (POS)
Hospital – Short-term
Participating since
Jul 8, 2004
Last certification
Jul 8, 2004
Beds
28
Ownership / control type
Other
Facility address
1900 South Broad Street
Philadelphia, PA 19145

National Provider Directory

National Provider Directory
Tax ID family
Scci Hospitals of America LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609871318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191452304",
            "telephone_number": "215-339-4100",
            "fax_number": "215-339-0482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191452304",
            "telephone_number": "215-339-4100",
            "fax_number": "215-339-0482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. AGNES LONG TERM INTENSIVE CARE, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRESKO",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER, VP FINANCE",
        "authorized_official_telephone_number": "215-339-4223",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "PA",
            "license": "97100101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.