OPHELIA MEDICAL GROUP, P.C. (NPI# 1376179150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376179150 |
| Entity Type | Organization |
| Organization Name | OPHELIA MEDICAL GROUP, P.C. |
| Practice Address |
161 Cecil B Moore Ave Apt 204 Philadelphia PA 19122-3243 |
| Mailing Address |
755 Park Ave Apt 4a New York NY 10021-4282 |
| Practice Telephone | 9173704364 |
| Mailing Telephone | 9173704364 |
| Enumeration Date | 2020-03-12 |
| Last Update Date | 2020-08-11 |
| Authorized Official Name | ARTHUR ROBINSON WILLIAMS IV (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2679841732 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WA0400X |
Registered Nurse Specialization: Addiction (Substance Use Disorder) |
Nursing Service Providers | ||
| Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
161 CECIL B MOORE AVE APT 204 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19122-3243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033719919 | Penn Diagnostic Co. | Clinic/Center | 2014 North 3rd St, Philadelphia, PA 19122 | 2020-10-29 |
| 1821639873 | Marshannie's Home Care, LLC | Home Health | 2143 N Front Street, Philadelphia, PA 19122 | 2019-10-01 |
| 1023679289 | 99 Adult Daycare II Inc | Home Health | 1533-39 N 7th St, Philadelphia, PA 19122 | 2019-06-27 |
| 1891232716 | Alexis Bender | Specialist/Technologist | 1801 Broad Street, Philadelphia, PA 19122 | 2017-01-30 |
| 1770933392 | Frederick Charles Bader | Psychologist | 1231 North Broad Street, 5th Floor, Philadelphia, PA 19122 | 2016-06-14 |
| 1316307192 | Vibrant Rehabilitation LLC | Occupational Therapy Assistant | 1533 - 39 N 7th St, 1/fl, Philadelphia, PA 19122 | 2016-03-07 |
| 1104285519 | Yi Liu | Occupational Therapy Assistant | 1537 North 7th Street, 2/fl, Philadelphia, PA 19122 | 2016-02-12 |
| 1558754580 | Icare Home Health LLC | Home Health | 1706 N. 2nd Street, R2, Philadelphia, PA 19122 | 2015-03-16 |
| 1912313347 | Eve Peters | Pharmacist | 2131 North Broad Street, Philadelphia, PA 19122 | 2014-07-07 |
| 1356618003 | Mohamed Alaoui Mdaghri | Dentist | 2017 N 2nd St, Philadelphia, PA 19122 | 2011-11-23 |
| Find all providers in zip 19122 | ||||
| Taxonomy Code | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487765020 | Isabelle Owen Arndt | Psychiatry & Neurology | 3900 Woodland Ave, Philadelphia, PA 19104-4551 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447602255 | New Freedom Behavioral Health, LLC | Psychiatry & Neurology | 72 Hillside Ln, Fallsington, PA 19054-1133 | 2016-07-05 |
| 1669840930 | Recovery Pathways | Psychiatry & Neurology | 396 Locust Ave, Washington, PA 15301-3357 | 2015-09-03 |
| 1083820377 | Reading Hospital | Psychiatry & Neurology | Sharp Avenue & Frances Street, Laureldale, PA 19605 | 2007-05-15 |
| 1447384193 | Frederick Rhode Stoddard II | Psychiatry & Neurology | 349 Lancaster Ave Ste 206, Haverford, PA 19041 | 2007-03-15 |
| 1366518847 | Kimberly Toland Jones | Psychiatry & Neurology | 850 W Lancaster Ave, 2nd Fl Lower Merion Counseling Services, Bryn Mawr, PA 19010-3220 | 2006-11-28 |
| 1578649299 | Roy Christopher Monsour | Psychiatry & Neurology | 119 Dakota Ln, Ligonier, PA 15658-3617 | 2006-10-27 |
| 1548203425 | James Jay Nocks | Psychiatry & Neurology | 920 E Baltimore Pike, Kennett Square, PA 19348-1800 | 2006-06-14 |
| 1134789662 | 2 Crows LLC | Psychiatry & Neurology | 722 E Butler Pike, Ambler, PA 19002-2310 | 2019-06-17 |
| 1669901658 | Gnh Bhimasani Inc | Psychiatry & Neurology | 321 Lois Ln, State College, PA 16801-2561 | 2017-06-05 |
| 1497299085 | Quantum Health Practice, LLC | Psychiatry & Neurology | 505 York Rd, Suite 7a, Jenkintown, PA 19046-2136 | 2016-12-15 |
| Find all providers with the same taxonomy | ||||
| City | PHILADELPHIA |
| Zip Code | 19122 |
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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.