NPIMap

Organization Active NPI

Mercy Neighborhood Ministries of Philadelphia, Inc

  • Adult Day Care Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1952759094
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
314250 - REGULAR Issued in PA
Legal business name
MERCY NEIGHBORHOOD MINISTRIES OF PHILADELPHIA, INC
Practice address
1939 W Venango St
Philadelphia, PA 19140-3919
Phone
(215) 227-4393
Fax
(215) 227-4394
NPI assigned
May 31, 2016
Last updated
May 31, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2016

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

Authorized official

Name
Ann Provost, RSM
Title
Executive Director
Phone
(215) 227-4393

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 314250 - REGULAR PA Primary

Addresses

Primary practice location

1939 W Venango St
Philadelphia, PA 19140-3919

Mailing address

1939 W Venango St
Philadelphia, PA 19140-3919
Phone (215) 227-4393

Other identifiers 1

IdentifierTypeStateIssuer
102263747MedicaidPA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464652800000",
    "number": "1952759094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 W VENANGO ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191403919",
            "telephone_number": "215-227-4393",
            "fax_number": "215-227-4394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1939 W VENANGO ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191403919",
            "telephone_number": "215-227-4393",
            "fax_number": "215-227-4394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY NEIGHBORHOOD MINISTRIES OF PHILADELPHIA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-31",
        "last_updated": "2016-05-31",
        "status": "A",
        "authorized_official_last_name": "PROVOST",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "215-227-4393",
        "authorized_official_credential": "RSM"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "PA",
            "license": "314250 - REGULAR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102263747",
            "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 May 31, 2016; 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.