NPIMap

Organization Active NPI

Thomas Jefferson University

  • Methadone Clinic
  • Philadelphia, PA
National Provider Identifier
1992824312
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
License
N8LT6601 Issued in PA
Legal business name
THOMAS JEFFERSON UNIVERSITY
Practice address
1233 Locust St
Suite 201
Philadelphia, PA 19107-5453
Phone
(215) 955-1952
Fax
(215) 568-6414
NPI assigned
Mar 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Authorized official

Name
Michelle Calvano, BA
Title
Business Manager
Phone
(215) 955-1952

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Methadone Clinic 261QM2800X N8LT6601 PA Primary

Addresses

Primary practice location

1233 Locust St
Suite 201
Philadelphia, PA 19107-5453

Mailing address

1233 Locust St
Suite 401
Philadelphia, PA 19107-5453
Phone (215) 955-1952

Other identifiers 1

IdentifierTypeStateIssuer
1007571300103MedicaidPA

Other names 1

  • Jefferson Univ-MATER Family Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Jefferson Community Onc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

1233 Locust St
Ste 201
Philadelphia, PA 19107
Phone (215) 955-1952

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1992824312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 LOCUST ST",
            "address_2": "SUITE 401",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075453",
            "telephone_number": "215-955-1952",
            "fax_number": "215-568-6414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 LOCUST ST",
            "address_2": "SUITE 201",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075453",
            "telephone_number": "215-955-1952",
            "fax_number": "215-568-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS JEFFERSON UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "CALVANO",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "215-955-1952",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "PA",
            "license": "N8LT6601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007571300103",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jefferson Univ-MATER Family Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 23, 2024; 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.