Individual provider Active NPI

Chioma Linda Iheagwara, DO

  • Psychiatry Physician
  • Philadelphia, PA
National Provider Identifier
1427182013
Registry record updated Jan 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0S013972 Issued in PA
Practice address
801 W Girard Ave
Philadelphia, PA 19122-4212
Phone
(215) 787-4380
Fax
(215) 787-2091
NPI assigned
Mar 15, 2007
Last updated
Jan 26, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2011

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 0S013972 PA Primary

Addresses

Primary practice location

801 W Girard Ave
Philadelphia, PA 19122-4212

Mailing address

801 W Girard Ave
Philadelphia, PA 19122-4212
Phone (215) 787-4380

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
I20070418000295 PA Practitioner - Psychiatry 7113022294 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0S013972PAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Belmont Behavioral Hospital, LLC CurrentSince Jul 1, 2015 Accepting new patients
Belmont Behavioral Hospital, LLC CurrentSince Jul 1, 2015 Accepting new patients
The Behavioral Wellness Center at Girard Past Accepting new patients

Locations

4200 Monument Rd
Philadelphia, PA 19131
Phone (215) 456-6611

4200 Monument Rd
#A
Philadelphia, PA 19131
Phone (215) 877-2000

Organizations & group practices 3

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": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296000000000",
    "number": "1427182013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 W GIRARD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191224212",
            "telephone_number": "215-787-4380",
            "fax_number": "215-787-2091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W GIRARD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191224212",
            "telephone_number": "215-787-4380",
            "fax_number": "215-787-2091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IHEAGWARA",
        "first_name": "CHIOMA",
        "middle_name": "LINDA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2011-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "0S013972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.