Divinetouch Medical Center LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

DIVINETOUCH MEDICAL CENTER LLC

Doing business as

Divinetouch Medical

Practice address

304 N Mitchell Rd
Mansfield, TX 76063-3449

Phone

(682) 422-9950

NPI assigned

Mar 15, 2022

Last updated

Apr 30, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tomi Ola-Peters, MDNPI 1760737142

Title

Director

Phone

(903) 932-7336

Specialties & licenses 1

Addresses

Other names 2

• DIVINETOUCH MEDICAL Doing business as
• DIVINETOUCH MEDICAL CENTER Former legal business name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tomi Omolara Ola-Peters, MD

  • Internal Medicine Physician
  • Mansfield, TX
  • NPI 1760737142
  Medicare reassignment NPD Authorized official
• Olivia Donata Ciccone, PA-C

  • Physician Assistant
  • Mansfield, TX
  • NPI 1578355533
  Medicare reassignment

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1346998713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 N MITCHELL RD",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633449",
            "telephone_number": "682-422-9950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N MITCHELL RD",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633449",
            "telephone_number": "682-422-9950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINETOUCH MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-15",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "OLA-PETERS",
        "authorized_official_first_name": "TOMI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "903-932-7336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DIVINETOUCH MEDICAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DIVINETOUCH MEDICAL CENTER",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "DIVINETOUCH MEDICAL CENTER",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Internal Medicine Physician in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (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.