Divine Internal Medicine LLC

Key facts

NPI: 1295032852
Entity type: Organization (NPI type 2)
Primary specialty: Internal Medicine Physician 207R00000X
Legal business name: DIVINE INTERNAL MEDICINE LLC
Practice address: 28 Flint Dr
North East, MD 21901-3746
Phone: (443) 877-6194
Fax: (443) 877-6235
NPI assigned: Feb 17, 2011
Organization subpart: No

Authorized official

Name: Dr. Cornelius Ope, M.D. NPI 1629066188
Title: Owner / President
Phone: (443) 877-6194

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 2

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

Cornelius O. Ope, MD Internal Medicine Physician · North East, MD · NPI 1629066188

Medicare reassignment NPD Authorized official INTERNAL MEDICINE · MD
Ema Ndi Sohna Psychiatric/Mental Health Nurse Practitioner · Newark, DE · NPI 1043649767

Medicare reassignment NPD MD

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
21D2048577	Divine Internal Medicine, LLC 28 Flint Drive, North East, MD 21901	Certificate of waiver	Oct 17, 2026

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MD

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20110614000147	MD	Part B Supplier - Clinic/Group Practice	3476730714	Receives reassigned benefits from 2 practitioners Practice locations: North East, MD

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	Primary
Internal Medicine Physician Group: 193200000X MULTI-SPECIALTY GROUP	207R00000X	Yes
Nuclear Medicine Physician Group: 193200000X MULTI-SPECIALTY GROUP	207U00000X
Diagnostic Radiology Physician Group: 193200000X MULTI-SPECIALTY GROUP	2085R0202X

Addresses

Primary practice location

28 Flint Dr
North East, MD 21901-3746

Mailing address

28 Flint Dr
North East, MD 21901-3746
Phone (443) 877-6194

Other identifiers

Identifier	Type	State	Issuer
217678	Other	MD	MEDICARE PTAN

Other providers in North East, MD

All providers in North East, MD · Internal Medicine Physician in Maryland

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2024. 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.
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.

Verify at the official NPI Registry.