DERRICK MATHIS (NPI# 1093086688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093086688 |
| Entity Type | Individual |
| Full Name | DERRICK MATHIS |
| Practice Address |
1551 N 29th St Suite 1 Philadelphia PA 19121-3620 |
| Mailing Address |
3202 Hamilton St Suite 1 Philadelphia PA 19104-2517 |
| Practice Telephone | 2679885613 |
| Mailing Telephone | 2679885613 |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2012-01-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 172A00000X | Driver | Other Service Providers | ||
| N | 372500000X | Chore Provider | Nursing Service Related Providers | ||
| N | 372600000X | Adult Companion | Nursing Service Related Providers | ||
| N | 374U00000X | Home Health Aide | Nursing Service Related Providers | ||
| N | 376K00000X | Nurse's Aide | Nursing Service Related Providers | ||
| Y | 172V00000X | Community Health Worker | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780822841 | Derrick John Mathis | Nursing Home Administrator | 9827 Sudley Manor Dr, Manassas, VA 20109-6232 | 2009-01-28 |
| Street Address |
1551 N 29TH ST SUITE 1 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19121-3620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154691731 | Donna M Alexander | Driver | 1551 N 29th St, Suite 2, Philadelphia, PA 19121-3620 | 2012-01-12 |
| 1972873560 | Womens Wellness Solutions | Medical Foods Supplier | 1551 N 29th St, Suite 2, Philadelphia, PA 19121-3620 | 2012-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356975445 | Shaun Shields | Specialist/Technologist | 1814 N. Broad Street, Philadelphia, PA 19121 | 2020-02-27 |
| 1225682503 | Ebony Qiana Morrison | Technician | 2202 Ridge Avenue, 2nd Floor Rm 203, Philadelphia, PA 19121 | 2019-07-25 |
| 1003398462 | Lyn Morrissa Meyerhoff | Specialist/Technologist | 1800 N. Broad Street, Philadelphia, PA 19121 | 2018-09-03 |
| 1356853576 | George E Kinsler | Pharmacist | 1941 N 24th St, Phila, PA 19121 | 2017-10-27 |
| 1205358652 | Perfect Love & Care LLC | Home Health | 1812 North Croskey Street, Philadelphia, PA 19121 | 2017-07-07 |
| 1427405257 | Rite-care Pharmacy Inc. | Pharmacy | 2213 Ridge Ave., Philadelphia, PA 19121 | 2016-05-23 |
| 1356735831 | Eguono Eduvie | Psychiatry & Neurology | 1700 N.broad St., 2nd Foor, Philadelphia, PA 19121 | 2015-03-24 |
| 1285986828 | Young Scholars Frederick Douglass Charter School | Local Education Agency (LEA) | 2118 W Norris St., Philadelphia, PA 19121 | 2012-10-05 |
| 1568764470 | Young Scholars Frederick Douglass Charter School | Local Education Agency (LEA) | 2118 W Norris St, Philadelphia, PA 19121 | 2010-11-29 |
| 1730408683 | Pamela Lewis | Registered Nurse | Serenity Court, 1221 N. 19th St., Philadelphia, PA 19121 | 2010-05-18 |
| Find all providers in zip 19121 | ||||
| Taxonomy Code | 172V00000X |
| Grouping | Other Service Providers |
| Classification | Community Health Worker |
| Community health workers (CHW) are lay members of communities who work either for pay or as volunteers in association with the local health care system in both urban and rural environments and usually share ethnicity, language, socioeconomic status and life experiences with the community members they serve. They have been identified by many titles such as community health advisors, lay health advocates, "promotores(as), outreach educators, community health representatives, peer health promoters, and peer health educators. CHWs offer interpretation and translation services, provide culturally appropriate health education and information, assist people in receiving the care they need, give informal counseling and guidance on health behaviors, advocate for individual and community health needs, and provide some direct services such as first aid and blood pressure screening. Some examples of these practitioners are Community Health Aides or Practitioners established under 25 USC §1616 (l) under HHS, Indian Health Service, Public Health Service. |
| Notes: Source: Health Resources and Services Administration, US Department of Health and Human Services – National Workforce Study on Community Health Workers, March, 2007. [7/1/2007: new] http://bhpr.hrsa.gov/healthworkforce/chw/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326654526 | Loving People Alliance Home Care LLC | Community Health Worker | 5622 Belmar Ter, Philadelphia, PA 19143-4713 | 2020-09-22 |
| 1275926081 | Robert Cox | Community Health Worker | 440 W Sedgwick St, Philadelphia, PA 19119-3045 | 2015-03-18 |
| 1396177135 | Darasia Selby | Community Health Worker | 6326 Baynton St, Philadelphia, PA 19144-1920 | 2013-08-03 |
| 1699017947 | Jimmy Bryant | Community Health Worker | 1213 Vine St Ste 121, Philadelphia, PA 19107-1111 | 2013-03-25 |
| 1861743916 | Monique Jardel Jamison | Community Health Worker | 6004 Buist Ave Fl 2, Philadelphia, PA 19142-3503 | 2012-09-28 |
| 1003193343 | Caitlin Douglass | Community Health Worker | 1230 Summer St, Philadelphia, PA 19107-1633 | 2011-11-15 |
| 1801129457 | Ava Adames | Community Health Worker | 12006 Bustleton Ave, Philadelphia, PA 19116-2108 | 2009-09-15 |
| 1275784704 | Benjamin Bender | Community Health Worker | 201 S 11th St, Philadelphia, PA 19107-5571 | 2008-10-02 |
| 1740416320 | Carlos M Morales Mitti | Community Health Worker | 1207 Chestnut St, 5th Floor, Philadelphia, PA 19107-4101 | 2009-06-09 |
| 1760659098 | Daniel Albert Leonard | Community Health Worker | 1301 S 3rd St, Philadelphia, PA 19147-6008 | 2008-05-15 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19121 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.