HENRIETTA JOHNSON MEDICAL CENTER – NPI #1770699621
Clinic/Center
HENRIETTA JOHNSON MEDICAL CENTER is an AHC clinic located in WILMINGTON, DE. NPPES has assigned the NPI number 1770699621 to HENRIETTA JOHNSON MEDICAL CENTER on August 22, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “HENRIETTA JOHNSON MEDICAL CENTER” is a dba name, the actual legal business name for this organization is SOUTHBRIDGE MEDICAL ADVISORY COUNCIL INC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)
The NPI profile was previously updated about 13 years ago on Jan 16, 2013. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for HENRIETTA JOHNSON MEDICAL CENTER below.
NPI Profile for
SOUTHBRIDGE MEDICAL ADVISORY COUNCIL INC
(about 20 years ago)
WILMINGTON, DE 19801 Phone: (302) 655-6187 Fax: (302) 655-6606
CHIEF EXECUTIVE OFFICER
Phone: (302) 655-6187
Identifiers for HENRIETTA JOHNSON MEDICAL CENTER
Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.
| Description | Issuer | State | Identifier |
|---|---|---|---|
| OTHER | TRAIL BLAZER | 458117 | |
| MEDICAID | DE | 0000332866 |
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 261QF0400X - Clinic/Center / Federally Qualified Health Center (FQHC) (Primary) |
||
| 207VG0400X - Obstetrics & Gynecology / Gynecology |
||
| 207Q00000X - Family Medicine |
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| 122300000X - Dentist |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.