NPIMap

Organization Active NPI

Cityblock Medical Practice DC PC

  • Multi-Specialty Clinic/Center
  • Washington, DC
National Provider Identifier
1861085102
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CITYBLOCK MEDICAL PRACTICE DC PC
Practice address
80 M St SE
Washington, DC 20003-3544
Phone
(833) 904-0620
NPI assigned
Feb 18, 2021
Last updated
Sep 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Authorized official

Name
Deborah Jordan
Title
Legal
Phone
(608) 335-0433

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X
Adult Mental Health Clinic/Center 261QM0850X
Multi-Specialty Clinic/Center 261QM1300X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

80 M St SE
Washington, DC 20003-3544

Mailing address

495 Flatbush Ave Ste C5
Brooklyn, NY 11225-3706

Other names 1

  • Cityblock Health Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663200000000",
    "number": "1861085102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 FLATBUSH AVE STE C5",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112253706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 M ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200033544",
            "telephone_number": "833-904-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITYBLOCK MEDICAL PRACTICE DC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-18",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "LEGAL",
        "authorized_official_telephone_number": "608-335-0433"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cityblock Health",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Cityblock Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.