Tajudeen Adebayo Kolawole, MBBS, MPH, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP022671 Issued in PA

Practice address

1 Medical Center Blvd Ste 407
Chester, PA 19013-3902

Phone

(610) 619-7413

Fax

(610) 874-7241

NPI assigned

Oct 19, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Centralized Comprehensive Human Services, Inc.Group PAC ID 4284535196, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

• Centralized Comprehensive Human Services, Inc.

  dba John F Kennedy Community MH MR Center

  • Community/Behavioral Health Agency
  • Philadelphia, PA
  • NPI 1942359120
  Medicare reassignment Care Compare group NPD
• Prospect Health Access Network, Inc.

  • Emergency Medicine Physician
  • Chester, PA
  • NPI 1568819084
  Medicare reassignment NPD
• Kola Group

  dba Modest Behavioral Health Center

  • Psychiatric/Mental Health Nurse Practitioner
  • Philadelphia, PA
  • NPI 1255018909
  NPD Authorized official
• Centralized Comprehensive Human Services, Inc.

  dba John F Kennedy Behavioral Health Center

  • Community/Behavioral Health Agency
  • Philadelphia, PA
  • NPI 1285756916
  NPD
• Centralized Comprehensive Human Services, Inc.

  dba John F Kennedy Behavioral Health Center

  • Community/Behavioral Health Agency
  • Philadelphia, PA
  • NPI 1578685624
  NPD
• Prospect Health Access Network, Inc.

  • Diagnostic Radiology Physician
  • Chester, PA
  • NPI 1154776797
  NPD
• Prospect Health Access Network, Inc.

  • Pediatrics Physician
  • Chester, PA
  • NPI 1780031005
  NPD

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1861091191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD STE 407",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190133902",
            "telephone_number": "610-619-7413",
            "fax_number": "610-874-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD STE 407",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190133902",
            "telephone_number": "610-619-7413",
            "fax_number": "610-874-7241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLAWOLE",
        "first_name": "TAJUDEEN",
        "middle_name": "ADEBAYO",
        "credential": "MBBS, MPH, CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP022671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• G. Jean Klein, RN
• Sarah Kline, RN
• Lisa Klinger, ARNP
• Mark D Koenig, BS
• Alexandra Kohn
• Jaewon Kong
• Garrett Koren, M.D.
• Monjama Korngor, CRNP-FP
• Nancy Karen Koshetar, D.D.S.
• Nina Kovalenko

• Psychiatric/Mental Health Nurse Practitioner in Chester, PA
• Providers in Chester, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.