THOMAS JEFFERSON UNIVERSITY


Address: 1021 South 21st Street, Philadelphia, PA 19146
Phone: 2157355979

THOMAS JEFFERSON UNIVERSITY (NPI# 1467547968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1467547968
Entity Type Organization
Organization Name THOMAS JEFFERSON UNIVERSITY
Other Organization Name THOMAS JEFFERSON UNIVERSITY DRUG AND ALCOHOL SERVICES
Practice Address 1021 South 21st Street
Philadelphia
PA 19146
Mailing Address 1021 S 21st St
Philadelphia
PA 19146-2634
Practice Telephone 2157355979
Mailing Telephone 2157909942
Mailing Fax Number 2157908617
Enumeration Date 2006-10-03
Last Update Date 2020-01-31
Authorized Official Name DR. ROBERT CHARLES STERLING (DIRECTOR)
Authorized Official Telephone 2157909942
Authorized Official Credential PHD
Is Organization Subpart Y
Parent Organization Name THOMAS JEFFERSON UNIVERSITY

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 103TA0400X Psychologist
Specialization: Addiction (Substance Use Disorder)
Behavioral Health & Social Service Providers
Y 251K00000X Public Health or Welfare 820023 PA Agencies

Other Provider Identifier

State Issuer Identifier Type Code
PA MEDICAID 1007571300083 01

Other Provider/Organization Names

Other Name Type Code
Thomas Jefferson University Drug and Alcohol Services Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1316390024 Thomas Jefferson University Special Hospital 900 Walnut St, Philadelphia, PA 19107-5509 2016-07-18
1750694055 Thomas Jefferson University Rehabilitation Unit 3801 Conshohocken Ave, Philadelphia, PA 19131-5530 2010-07-15
1235378209 Thomas Jefferson University Social Worker 130 S 9th St, Suite 647, Philadelphia, PA 19107-5233 2009-02-13
1508011313 Thomas Jefferson University Community/Behavioral Health 1233 Locust St, Suite 201, Philadelphia, PA 19107-5453 2008-11-20
1245495944 Thomas Jefferson University Neurological Surgery 909 Walnut St, 3rd Floor, Philadelphia, PA 19107-5211 2008-07-22
1992824312 Thomas Jefferson University Clinic/Center 1233 Locust St, Suite 201, Philadelphia, PA 19107-5453 2007-03-28
1972622306 Thomas Jefferson University Clinic/Center 1239 Spring Garden St, Philadelphia, PA 19123-3206 2007-03-28
1124147277 Thomas Jefferson University General Acute Care Hospital 111 S 11th St, Suite 8270, Philadelphia, PA 19107-4824 2007-03-28
1124195854 Thomas Jefferson University Specialist 111 S 11th St, Suite 4240, Philadelphia, PA 19107-4824 2006-11-29

Other Data Sources

Entity Type Entity Name Entity Address
Washington State Corporations THOMAS JEFFERSON UNIVERSITY 1020 Walnut St, Philadelphia, PA 19107
System for Award Management (SAM) Entities THOMAS JEFFERSON UNIVERSITY HOSPITAL 111 S 11th St, Philadelphia, PA 19107-4824

Office Location

Street Address 1021 SOUTH 21ST STREET
City PHILADELPHIA
State PA
Zip Code 19146

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1114545977 Puentes De Salvd Clinic/Center 1700 South Street, Philadelphia, PA 19146 2020-07-08
1407480155 Mutiat Ajibade Nurse Practitioner 1401 S. 31 Street, Phialdelphia, PA 19146 2020-03-02
1003453952 Bridget Smith Psychologist Stratton Hall, 3201 Chestnut St., 2nd Floor, Philadelphia, PA 19146 2019-12-10
1730678012 Christina Martindale Nurse Anesthetist, Certified Registered 917 S 15th Street, Philadelphia, PA 19146 2018-05-02
1598289456 Allison Ortolano Speech-Language Pathologist 1933 Montrose St., Philadelphia, PA 19146 2017-08-01
1033630116 Jami F Young Psychologist 2716 South Street, Behavioral Health 8/8473, Philadelphia, PA 19146 2017-06-29
1336678788 Joshua Ryan Fidler Occupational Therapist 2223 Wharton Street, Philadelphia, PA 19146 2017-06-08
1912357930 Mei Lan Natalie Lau Pharmacist 3000-02 Reed Street, Philadelphia, PA 19146 2016-06-21
1417354887 Brandy Mitchell Specialist 1608 Webster Street, Philadelphia, PA 19146 2014-12-01
1942638101 Woong Yi Pharmacist 1155 S.mole St, Philadelphia, PA 19146 2013-10-28
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Taxonomy Information

Taxonomy Code 251K00000X
Grouping Agencies
Classification Public Health or Welfare

Taxonomy Definition

Definition to come...

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Competitor

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City PHILADELPHIA
Zip Code 19146

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Dataset Information

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.

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