NPIMap

Organization Active NPI

Public Health Mangement Corporation

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
National Provider Identifier
1811568769
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PUBLIC HEALTH MANGEMENT CORPORATION
Practice address
501 S 54TH St
Philadelphia, PA 19143-1900
Phone
(215) 731-2406
Fax
(267) 765-2325
NPI assigned
Jul 1, 2021
Last updated
Jul 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Authorized official

Name
Frank Killian
Title
Dir. of Finance and Reg. Affairs
Phone
(215) 985-2514

Specialties & licenses 1

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

Addresses

Primary practice location

501 S 54TH St
Philadelphia, PA 19143-1900

Mailing address

1500 Market St.
Centre Square East 17TH FL
Philadelphia, PA 19102
Phone (215) 731-2406

Other names 1

  • PHMC Health Center on Cedar Avenue Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

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
O20211115002365 PA Part A Provider - Federally Qualified Health Center (FQHC) 1850307406 Practice locations: Philadelphia, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811568769. Details of each certification follow.

Federally qualified health center certification: CCN 731950

Legal name
PUBLIC HEALTH MANAGEMENT CORPORATION
Doing business as
PHMC HEALTH CENTER ON CEDAR AVENUE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 15, 2021
Last certification
Nov 15, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 26, 1972 in PA
Enrollment address
501 S 54TH St
Philadelphia, PA 19143-1900

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 17

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

View all 17

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2236609PHMC Health Center on Cedar Avenue501 S 54TH St, Philadelphia, PA 19143Provider-performed microscopySep 16, 2027

National Provider Directory

National Provider Directory
Tax ID family
Public Health Managment Corporation40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

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

View all 39

Ownership & related parties

All disclosed owners & managing parties 20

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Patrick Eiding Individual Corporate DirectorBoard Member Jan 1, 2002
Public Health Management Corporation Organization, Philadelphia, PA Non-profit 5% Or Greater Direct Ownership Interest Jun 1, 2021
Denise H Christian Individual Corporate DirectorBoard Member Jan 1, 1991
Stephen P Fera Individual Corporate OfficerSecretary Jun 1, 2015
Corporate DirectorBoard Member Jan 1, 2007
Kenneth J Veit Individual Corporate DirectorBoard Member Jan 1, 1988
Susan Sherman Individual Corporate DirectorBoard Member Jan 1, 2005
Dorothy P Mann Individual Corporate DirectorBoard Member Jan 1, 1983
Kathleen Kinslow Individual Corporate OfficerTreasurer Jun 1, 2015
Corporate DirectorBoard Member Jan 1, 2012
James Oram Individual Corporate DirectorBoard Member Jun 1, 2013
Theodore a. Christopher Individual Corporate DirectorBoard Member Jan 1, 2009
Frank Killian Individual W-2 Managing EmployeeDirector of Finance Sep 20, 2015
Renee Cardwell Hughes Individual Corporate DirectorBoard Member Jan 1, 2007
Sharon M Gallagher Individual Corporate DirectorBoard Member Jan 1, 2000
Dinetta Armstrong Individual W-2 Managing Employee Sep 20, 2015
Michael Pearson Individual Corporate OfficerChairman Jun 1, 2015
Corporate DirectorBoard Member Jan 1, 2008
George E Downs Individual Corporate DirectorBoard Member Jan 1, 2005
J Douglas Macbride Individual Corporate DirectorBoard Member Jan 1, 1977
Curtis Schroder Individual Corporate DirectorBoard Member Jan 1, 2012
Andrew Carter Individual Corporate DirectorBoard Member Dec 1, 2014
Richard J Cohen Individual Corporate DirectorCeo/President May 5, 2006

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 7

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": "1625097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625097600000",
    "number": "1811568769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 MARKET ST.",
            "address_2": "CENTRE SQUARE EAST 17TH FL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-731-2406",
            "fax_number": "267-765-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S 54TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431900",
            "telephone_number": "215-731-2406",
            "fax_number": "267-765-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HEALTH MANGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A",
        "authorized_official_last_name": "KILLIAN",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "DIR. OF FINANCE AND REG. AFFAIRS",
        "authorized_official_telephone_number": "215-985-2514"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHMC Health Center on Cedar Avenue",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.