Individual provider Active NPI

Anika Dore Vaughn-Cooke, M.D.

  • Psychiatry Physician
  • Philadelphia, PA
National Provider Identifier
1376779470
Registry record updated Jun 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD422526 Issued in PA
Practice address
7149 Boyer Street
Philadelphia, PA 19119
Phone
(215) 605-7651
NPI assigned
Jun 3, 2009
Last updated
Jun 3, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD422526 PA Primary

Addresses

Primary practice location

7149 Boyer Street
Philadelphia, PA 19119

Mailing address

7149 Boyer St
Philadelphia, PA 19119-1813
Phone (215) 605-7651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090803000399 PA Practitioner - Psychiatry 7911050315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Jefferson Medical College of Thomas Jefferson University, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Co Mhar IncGroup PAC ID 1951398452, 22 clinicians

Practice addresses (Care Compare)

2055 E Allegheny Ave
Philadelphia, PA 19134-3832
Phone (215) 427-5800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Comhar, Inc Psychiatry CurrentSince Aug 26, 2015 Accepting new patients
Comhar Inc CurrentSince Aug 26, 2015 Accepting new patients

Locations

100 W Lehigh Ave
Philadelphia, PA 19133
Phone (215) 203-3000

2055 E Allegheny Ave
Philadelphia, PA 19134
Phone (215) 427-5800

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243987200000",
    "number": "1376779470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7149 BOYER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191191813",
            "telephone_number": "215-605-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7149 BOYER STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19119",
            "telephone_number": "215-605-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN-COOKE",
        "first_name": "ANIKA",
        "middle_name": "DORE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-03",
        "last_updated": "2009-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD422526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.