DR. KRISTI L DIVELY (NPI# 1063447852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063447852 |
| Entity Type | Individual |
| Full Name | DR. KRISTI L DIVELY |
| Credential | D.O. |
| Practice Address |
1170 S State St Ephrata PA 17522-2601 |
| Mailing Address |
1170 S. State Street Ephrata PA 17522 |
| Practice Telephone | 7178598000 |
| Practice Fax Number | 7178596313 |
| Mailing Telephone | 7178598000 |
| Mailing Fax Number | 7178596313 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2019-05-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
OS012313 | PA | Allopathic & Osteopathic Physicians |
| Y | 207V00000X | Obstetrics & Gynecology | OS012313 | PA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 18e S 7th St, Akron, PA 175011363 | 9253784601 | |
| 16c S 7th St, Akron, PA 175011331 | 9253784601 |
| Street Address |
1170 S STATE ST |
| City | EPHRATA |
| State | PA |
| Zip Code | 17522-2601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184239477 | Kylee Ann Metz | Counselor | 1170 S State St, Ephrata, PA 17522-2601 | 2020-09-13 |
| 1861006058 | Michael Bertolino | Counselor | 1170 S State St, Ephrata, PA 17522-2601 | 2020-09-03 |
| 1750994505 | Kristen Benner | Counselor | 1170 S State St, Ephrata, PA 17522-2601 | 2020-08-30 |
| 1093336588 | Lindsey Kathryn Richards | Counselor | 1170 S State St, Ephrata, PA 17522-2601 | 2020-05-06 |
| 1265067144 | Lauren E Mcclain | Counselor | 1170 S State St, Ephrata, PA 17522-2601 | 2020-03-11 |
| 1730723875 | Cole E Glaser | Counselor | 1170 S State St, Ephrata, PA 17522-2601 | 2019-11-01 |
| 1639713779 | Ronald Anthony Sexton | Social Worker | 1170 S State St, Ephrata, PA 17522-2601 | 2019-11-01 |
| 1699319756 | Kate Ramsey | Counselor | 1170 S State St, Ephrata, PA 17522-2601 | 2019-11-01 |
| 1508400656 | David L Bankert | Counselor | 1170 S State St, Ephrata, PA 17522-2601 | 2019-11-01 |
| 1275177412 | Christopher W Brander | Counselor | 1170 S State St, Ephrata, PA 17522-2601 | 2019-10-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427667336 | Indiju 4 Dental LLC | Clinic/Center | 4240 Oregeon Pk., Ephrata, PA 17522 | 2020-07-27 |
| 1134778251 | Anna Thornton | Pharmacist | Ephrata Outpatient Pharmacy-wellspan, 183 N. Reading Road, Suite 9, Ephrata, PA 17522 | 2019-09-11 |
| 1316320898 | Shivani Bista | Obstetrics & Gynecology | 175 Martin Ave Ste 125, Ephrata, PA 17522 | 2015-07-02 |
| 1336583475 | Ccjp, Inc. | In Home Supportive Care | 1060 S. State Street, Suite E, Ephrata, PA 17522 | 2013-04-19 |
| 1548503600 | Timothy Lawrence Basom | Physical Therapist | 136 E Lake St, Ephrata, PA 17522 | 2013-03-27 |
| 1316228406 | Cheryl L. Stephen | Nurse Practitioner | 466 N. Reading Rd, Suite 301, Ephrata, PA 17522 | 2011-09-01 |
| 1174833743 | T. W. Ponessa and Associates Counseling Services, Inc. | Community/Behavioral Health | 803 Oak Boulevard, Ephrata, PA 17522 | 2010-10-18 |
| 1487964953 | T. W. Ponessa and Associates Counseling Services, Inc. | Community/Behavioral Health | 957 Hammon Avenue, Ephrata, PA 17522 | 2010-10-18 |
| 1396957148 | Carl Richard Hankel | Nurse Practitioner | 4237 Oregon Pike, Worknet Occupational Medicine, Ephrata, PA 17522 | 2007-05-04 |
| 1396877726 | Regional Gastroenterology Associates of Lancaster, Ltd | Clinic/Center | 4140 Oregon Pike, Ephrata, PA 17522 | 2007-03-12 |
| Find all providers in zip 17522 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316320898 | Shivani Bista | Obstetrics & Gynecology | 175 Martin Ave Ste 125, Ephrata, PA 17522 | 2015-07-02 |
| 1437512258 | Robin Woollens Lynn | Obstetrics & Gynecology | 175 Martin Ave, Suite 125, Ephrata, PA 17522-1761 | 2016-03-30 |
| 1245587740 | Sonia Shashank Shah | Obstetrics & Gynecology | 175 Martin Ave, Ephrata, PA 17522-1761 | 2012-08-14 |
| 1891890232 | John Carini | Obstetrics & Gynecology | 175 Martin Ave, Suite125, Ephrata, PA 17522-1761 | 2006-09-13 |
| 1609978741 | Tanya O'connor | Obstetrics & Gynecology | 175 Martin Ave, Suite 125, Ephrata, PA 17522-1761 | 2006-09-01 |
| 1760593560 | Ann Marie Bybel | Obstetrics & Gynecology | 175 Martin Ave, Ephrata, PA 17522-1761 | 2006-08-31 |
| 1023088051 | Jonathan H Griner | Obstetrics & Gynecology | 175 Martin Ave, Suite 125, Ephrata, PA 17522-1761 | 2006-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871103069 | Kongoormutt Ramakrishna Bhat | Obstetrics & Gynecology | 3 Jamison Dr, York, PA 17402-2615 | 2020-08-03 |
| 1811515307 | St. Luke's Physician Group, Inc. | Obstetrics & Gynecology | 3311 Nazareth Rd Fl 1, Easton, PA 18045-2017 | 2020-07-10 |
| 1962027557 | Tal Avigal Lee | Obstetrics & Gynecology | 1109 Green St Apt 11, Philadelphia, PA 19123-3326 | 2020-06-10 |
| 1184257826 | St. Luke's Physician Group Inc., Dba | Obstetrics & Gynecology | 2925 William Penn Hwy Ste 104, Easton, PA 18045-5283 | 2020-02-21 |
| 1821633694 | Julia Claire Moran | Obstetrics & Gynecology | 1800 Union Ave, Natrona Heights, PA 15065-2201 | 2019-11-15 |
| 1851957948 | Stacie Marie Rickley | Obstetrics & Gynecology | 1265 New Germany Rd, Summerhill, PA 15958-5301 | 2019-05-14 |
| 1477011401 | Diane D. Harrison | Obstetrics & Gynecology | 236 Philip Pl, Philadelphia, PA 19106-3902 | 2019-03-08 |
| 1003387572 | Carissa Susan Mcilwain | Obstetrics & Gynecology | 25 Bala Ave Ste 205, Bala Cynwyd, PA 19004-3215 | 2018-12-10 |
| 1720570963 | Tiffany Fernandes Gee | Obstetrics & Gynecology | 3401 N Broad St Fl 7, Philadelphia, PA 19140-5189 | 2018-06-04 |
| 1689164196 | St. Luke's Physician Group Inc. | Obstetrics & Gynecology | 450 Chew St Ste 204, Allentown, PA 18102-3434 | 2018-05-10 |
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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.