NPIMap

Organization Active NPI

Bethanna

  • Community/Behavioral Health Agency
  • Philadelphia, PA
National Provider Identifier
1801300512
Registry record updated Nov 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
100910
Legal business name
BETHANNA
Practice address
2500 Wharton St
Philadelphia, PA 19146-3942
Phone
(215) 355-6500
NPI assigned
Nov 17, 2017
Last updated
Nov 17, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2017

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

Authorized official

Name
John Michael Chase
Title
Cio
Phone
(215) 355-6500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 100910 Primary
Community/Behavioral Health Agency 251S00000X 143290 PA

Addresses

Primary practice location

2500 Wharton St
Philadelphia, PA 19146-3942

Mailing address

1030 Second Street Pike
Southampton, PA 18966-3955

Other identifiers 1

IdentifierTypeStateIssuer
100751341MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Bethanna7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1510876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510876800000",
    "number": "1801300512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 SECOND STREET PIKE",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189663955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 WHARTON ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191463942",
            "telephone_number": "215-355-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANNA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-17",
        "last_updated": "2017-11-17",
        "status": "A",
        "authorized_official_last_name": "CHASE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CIO",
        "authorized_official_telephone_number": "215-355-6500"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": "100910",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "143290",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100751341",
            "state": "PA"
        }
    ],
    "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 Nov 17, 2017; 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.