Kola Group

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

KOLA GROUP

Practice address

5438 N Lawrence St
Philadelphia, PA 19120-2804

Phone

(610) 563-3767

NPI assigned

Jul 3, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tajudeen Adebayo KolawoleNPI 1861091191

Title

CRNP

Phone

(610) 563-3767

Specialties & licenses 1

Addresses

Other names 1

• MODEST BEHAVIORAL HEALTH CENTER Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tajudeen Adebayo Kolawole, MBBS, MPH, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Chester, PA
  • NPI 1861091191
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688342400000",
    "number": "1255018909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 SELMA ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5438 N LAWRENCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202804",
            "telephone_number": "610-563-3767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOLA GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A",
        "authorized_official_last_name": "KOLAWOLE",
        "authorized_official_first_name": "TAJUDEEN",
        "authorized_official_middle_name": "ADEBAYO",
        "authorized_official_title_or_position": "CRNP",
        "authorized_official_telephone_number": "610-563-3767"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MODEST BEHAVIORAL HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deirdre Kokasko
• Olena Kokhanova, MS
• Konstandina Kokinakos, DO
• Samantha Kokoska, MD
• Kokroo Medical Associates,PC
• Ana S Kolansky, MD
• Daniel M Kolansky, MD
• Kara Kolar
• Sharon Kolasinski, MD
• Amber Kolb

• Psychiatric/Mental Health Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.