Active NPI
Delisa Branch
- Community/Behavioral Health Agency
- Philadelphia, PA
National Provider Identifier
1881288603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- BH005179
- Practice address
- 1633 N Dover St
Philadelphia, PA 19121-2707 - Phone
- (215) 796-8309
- NPI assigned
- Feb 22, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | BH005179 | PA | Primary |
Addresses
Primary practice location
1633 N Dover St
Philadelphia, PA 19121-2707
Mailing address
1633 N Dover St
Philadelphia, PA 19121-2707
Phone (215) 796-8309
Electronic endpoints 8
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Pennsylvania | ||
| CONNECT URL | Pennsylvania | ||
| CONNECT URL | Pennsylvania | ||
| Other URL | Philadelphia | ||
| CONNECT URL | Pennsylvania | ||
| CONNECT URL | Pennsylvania | ||
| CONNECT URL | Pennsylvania | ||
| CONNECT URL | URL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BH005179 | PA | MD | Community/Behavioral Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615507200000",
"number": "1881288603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1633 N DOVER ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191212707",
"telephone_number": "215-796-8309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1633 N DOVER ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191212707",
"telephone_number": "215-796-8309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANCH",
"first_name": "DELISA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-22",
"last_updated": "2021-03-12",
"certification_date": "2021-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "PA",
"license": "BH005179",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Pennsylvania",
"affiliation": "N",
"address_1": "1633 N Dover St",
"city": "Philadelphia",
"state": "PA",
"country_code": "US",
"postal_code": "191212707",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Pennsylvania",
"affiliation": "N",
"address_1": "1633 N Dover St",
"city": "Philadelphia",
"state": "PA",
"country_code": "US",
"postal_code": "191212707",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Pennsylvania",
"affiliation": "N",
"address_1": "1633 N Dover St",
"city": "Philadelphia",
"state": "PA",
"country_code": "US",
"postal_code": "191212707",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Philadelphia",
"affiliation": "N",
"address_1": "1633 N Dover St",
"city": "Philadelphia",
"state": "PA",
"country_code": "US",
"postal_code": "191212707",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Pennsylvania",
"affiliation": "N",
"address_1": "1633 N Dover St",
"city": "Philadelphia",
"state": "PA",
"country_code": "US",
"postal_code": "191212707",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Pennsylvania",
"affiliation": "N",
"address_1": "1633 N Dover St",
"city": "Philadelphia",
"state": "PA",
"country_code": "US",
"postal_code": "191212707",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Pennsylvania",
"affiliation": "N",
"address_1": "1633 N Dover St",
"city": "Philadelphia",
"state": "PA",
"country_code": "US",
"postal_code": "191212707",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "URL",
"affiliation": "N",
"address_1": "1633 N Dover St",
"city": "Philadelphia",
"state": "PA",
"country_code": "US",
"postal_code": "191212707",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Mar 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.