Phillip Divon
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Yeadon, PA
NPI 1154280931 · NPPES record last updated Jan 19, 2026
Key facts
- NPI
- 1154280931
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- SP034951 (PA)
- Practice address
- 939 Bell Ave
Yeadon, PA 19050-3704 - Phone
- (215) 681-7242
- NPI assigned
- Jan 19, 2026
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Inpatient Consultants of Pennsylvania PC
NJ Pacs 2 PA
Practice addresses (Care Compare)
1343 W Baltimore Pike
Media, PA 19063-5519
Phone (484) 443-0070
411 N Middletown Rd
Media, PA 19063-4059
Phone (610) 565-8717
700 N Franklin St
West Chester, PA 19380-2334
Phone (610) 696-5211
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260415004019 | PA | Practitioner - Nurse Practitioner | 9931675196 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP034951 | PA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Strategies in Transition | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | SP034951 | PA | Yes |
Addresses
Primary practice location
939 Bell Ave
Yeadon, PA 19050-3704
Mailing address
939 Bell Ave
Yeadon, PA 19050-3704
Phone (215) 681-7242
Other providers in Yeadon, PA
- Rosemary D'Anella
- Brittany Rhenae Daniels
- Dependable Homecare Agency
- Alyanna Diaz
- Divine Providence Village
- Donna L. Elcock, O.D.
- Wade Duncan
- Donna Leonne Elcock
- Fajr Khalifah Elhadi
- Leeanne Elhadi
All providers in Yeadon, PA · Psychiatric/Mental Health Nurse Practitioner in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.