NPIMap

Organization Active NPI

Public Health Management Corporation

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
National Provider Identifier
1679133268
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PUBLIC HEALTH MANAGEMENT CORPORATION
Practice address
315 S Broad St
Philadelphia, PA 19107-5213
Phone
(215) 735-4847
NPI assigned
Jun 17, 2019
Last updated
Jan 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Authorized official

Name
Dinetta Armstrong
Title
Managing Director
Phone
(215) 985-2553

Specialties & licenses 1

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

Addresses

Primary practice location

315 S Broad St
Philadelphia, PA 19107-5213

Mailing address

1500 Market St.
LM 500 West Tower
Philadelphia, PA 19102
Phone (215) 985-2500

Other names 1

  • Broad St. Ministry Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060504000213 PA Part B Supplier - Clinic/Group Practice 1850307406 Receives reassigned benefits from 109 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Philadelphia, PA; Flourtown, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679133268. Details of each certification follow.

  • CCN 731807 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 731807

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
PUBLIC HEALTH MANAGEMENT CORPORATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 11, 2020
Last certification
Feb 11, 2020
Ownership / control type
For profit – corporation
Facility address
315 S Broad Street
Phila, PA 19107

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 17

National Provider Directory

National Provider Directory

Locations

315 S Broad St
Philadelphia, PA 19107
Phone (215) 735-4847

501 S 54th St
Philadelphia, PA 19143
Phone (215) 581-2046

Practitioners & affiliated clinicians

Practitioners 6

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": "1560729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578355200000",
    "number": "1679133268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 MARKET ST.",
            "address_2": "LM 500 WEST TOWER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-985-2500",
            "fax_number": "267-765-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075213",
            "telephone_number": "215-735-4847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HEALTH MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-17",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A",
        "authorized_official_last_name": "ARMSTRONG",
        "authorized_official_first_name": "DINETTA",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "215-985-2553"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broad St. Ministry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.