NPIMap

Organization Active NPI

Sayre Health Center

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
National Provider Identifier
1831209113
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SAYRE HEALTH CENTER
Practice address
5800 Walnut Street Rear
Philadelphia, PA 19139
Phone
(215) 474-4444
Fax
(215) 474-6021
NPI assigned
Aug 30, 2006
Last updated
Jun 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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

Authorized official

Name
Kent Bream, MDNPI 1538196423
Title
Medical Director
Phone
(215) 474-4411

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

5800 Walnut Street Rear
Philadelphia, PA 19139

Mailing address

5800 Walnut Street Rear
Philadelphia, PA 19139-3836
Phone (215) 474-4411

Other identifiers 1

IdentifierTypeStateIssuer
1019704400001MedicaidPA

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061114000505 PA Part A Provider - Federally Qualified Health Center (FQHC) 7416955000 Practice locations: Philadelphia, PA
O20220317002858 PA Part B Supplier - Clinic/Group Practice 7416955000 Receives reassigned benefits from 27 practitioners
Practice locations: Philadelphia, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831209113. Details of each certification follow.

Federally qualified health center certification: CCN 391969

Legal name
SAYRE HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 23, 2007
Last certification
Jan 23, 2007
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 7, 2004 in PA
Enrollment address
5800 Walnut St Rear
Philadelphia, PA 19139-3836

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
39D1059431Sayre Health Center5800 Walnut Street Rear, Philadelphia, PA 19139Provider-performed microscopySep 28, 2026

National Provider Directory

National Provider Directory

Locations

5800 Walnut St
Rear
Philadelphia, PA 19139
Phone (215) 474-4444

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73304
  • FHIR API: https://fhir4.healow.com/fhir/r4/CHJCDD

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Lisa M Lewis Individual Corporate DirectorBoard Member Mar 17, 2011
Tanya M Thompson Individual Corporate DirectorBoard Member Oct 15, 2009
Nancy Winder Individual Corporate DirectorBoard Member Jun 26, 2006
Cory Bowman Individual Corporate DirectorBoard Member Jun 26, 2006
Frederick M Carey Individual Corporate OfficerExecutive Director Dec 30, 2009 100%
W-2 Managing EmployeeExecutive Director Dec 30, 2009 100%
Patricia L. Bell Individual Corporate DirectorBoard Member Sep 19, 2013
Shonte Eley Individual Corporate DirectorBoard Member May 15, 2014
Mary-Martha Johnson Individual Corporate DirectorBoard Member Sep 15, 2011
Tonya R Robinson Individual Corporate DirectorBoard Member Oct 15, 2009

Practitioners & affiliated clinicians

Practitioners 35

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.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340150400000",
    "number": "1831209113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 WALNUT STREET REAR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393836",
            "telephone_number": "215-474-4411",
            "fax_number": "215-474-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 WALNUT STREET REAR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19139",
            "telephone_number": "215-474-4444",
            "fax_number": "215-474-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAYRE HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-06-20",
        "status": "A",
        "authorized_official_last_name": "BREAM",
        "authorized_official_first_name": "KENT",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "215-474-4411",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019704400001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.