NPIMap

Organization Active NPI

Ephratah Health Group LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Henrico, VA
National Provider Identifier
1740057751
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
EPHRATAH HEALTH GROUP LLC
Practice address
8726 Landmark Rd
Henrico, VA 23228-2802
Phone
(347) 635-2021
NPI assigned
Dec 8, 2023
Last updated
Dec 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Authorized official

Name
Moradeke OkunoyeNPI 1417655648
Title
Manager
Phone
(347) 635-2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

8726 Landmark Rd
Henrico, VA 23228-2802

Mailing address

8726 Landmark Rd
Henrico, VA 23228-2802
Phone (347) 635-2021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260203001029 VA Part B Supplier - Clinic/Group Practice 8820576630 Receives reassigned benefits from 1 practitioner
Practice locations: Midlothian, VA

National Provider Directory

National Provider Directory

Locations

8726 Landmark Rd
Henrico, VA 23228
Phone (347) 635-2021

Practitioners & affiliated clinicians

Practitioners 26

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.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1701993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701993600000",
    "number": "1740057751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8726 LANDMARK RD",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232282802",
            "telephone_number": "347-635-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8726 LANDMARK RD",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232282802",
            "telephone_number": "347-635-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPHRATAH HEALTH GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-08",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A",
        "authorized_official_last_name": "OKUNOYE",
        "authorized_official_first_name": "MORADEKE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "347-635-2021"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrico, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.