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).
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 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
PA | MEDICAID | 1007571300083 | 01 |
Other Name | Type Code |
---|---|
Thomas Jefferson University Drug and Alcohol Services | Doing Business As Name - Organization |
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 |
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 |
Street Address |
1021 SOUTH 21ST STREET |
City | PHILADELPHIA |
State | PA |
Zip Code | 19146 |
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 |
Find all providers in zip 19146 |
Taxonomy Code | 251K00000X |
Grouping | Agencies |
Classification | Public Health or Welfare |
Definition to come... |
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1356525505 | Sobriety Through Out Patient Inc | Public Health or Welfare | 2534-36 N. Broad St, Suite 200, Philadelphia, PA 19132-4013 | 2007-12-24 |
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1881716223 | Merakey Parkside Recovery | Public Health or Welfare | 5429 Germantown Ave, Philadelphia, PA 19144-2223 | 2007-04-05 |
1689700551 | Men & Women for Human Excellence, Inc. | Public Health or Welfare | 2603 Cecil B Moore Ave, Philadelphia, PA 19121-2826 | 2007-02-26 |
Find all providers in PHILADELPHIA |
City | PHILADELPHIA |
Zip Code | 19146 |
Please comment or provide details below to improve the information on THOMAS JEFFERSON UNIVERSITY.
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.