MR. SHINICHI DAIMYO (NPI# 1275041477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275041477 |
| Entity Type | Individual |
| Full Name | MR. SHINICHI DAIMYO |
| Credential | PMHNP-BC, CRNP |
| Practice Address |
2144 Cecil B Moore Ave Philadelphia PA 19121-4014 |
| Practice Telephone | 2153206187 |
| Mailing Telephone | 2153206187 |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2019-01-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
SP019201 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2144 CECIL B MOORE AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19121-4014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902122567 | Mudit Gilotra | Family Medicine | 2144 Cecil B Moore Ave, Philadelphia, PA 19121-4014 | 2010-04-07 |
| 1417569120 | Vishal Snehal Shah | Counselor | 2144 Cecil B Moore Ave, Philadelphia, PA 19121-4014 | 2020-08-24 |
| 1386284271 | Christine Zacchei | Social Worker | 2144 Cecil B Moore Ave, Philadelphia, PA 19121-4014 | 2020-01-09 |
| 1760035653 | Karen Engelke | Dental Hygienist | 2144 Cecil B Moore Ave, Philadelphia, PA 19121-4014 | 2019-07-19 |
| 1568935195 | Genevieve Marie Gellert | Social Worker | 2144 Cecil B Moore Ave, Philadelphia, PA 19121-4014 | 2019-01-07 |
| 1437684966 | Danielle Baurer | Family Medicine | 2144 Cecil B Moore Ave, Philadelphia, PA 19121-4014 | 2017-04-21 |
| 1780032136 | Mary Jo Kasenchak | Dentist | 2144 Cecil B Moore Ave, Philadelphia, PA 19121-4014 | 2016-05-26 |
| 1073969929 | Nayeli Arguelles Spahr | Family Medicine | 2144 Cecil B Moore Ave, Philadelphia, PA 19121-4014 | 2016-05-10 |
| 1336525708 | Project Home | Pharmacy | 2144 Cecil B Moore Ave, Philadelphia, PA 19121-4014 | 2015-08-07 |
| 1124400213 | Janine Burkhardt | Dentist | 2144 Cecil B Moore Ave, Philadelphia, PA 19121-4014 | 2015-06-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356975445 | Shaun Shields | Specialist/Technologist | 1814 N. Broad Street, Philadelphia, PA 19121 | 2020-02-27 |
| 1225682503 | Ebony Qiana Morrison | Technician | 2202 Ridge Avenue, 2nd Floor Rm 203, Philadelphia, PA 19121 | 2019-07-25 |
| 1003398462 | Lyn Morrissa Meyerhoff | Specialist/Technologist | 1800 N. Broad Street, Philadelphia, PA 19121 | 2018-09-03 |
| 1356853576 | George E Kinsler | Pharmacist | 1941 N 24th St, Phila, PA 19121 | 2017-10-27 |
| 1205358652 | Perfect Love & Care LLC | Home Health | 1812 North Croskey Street, Philadelphia, PA 19121 | 2017-07-07 |
| 1427405257 | Rite-care Pharmacy Inc. | Pharmacy | 2213 Ridge Ave., Philadelphia, PA 19121 | 2016-05-23 |
| 1356735831 | Eguono Eduvie | Psychiatry & Neurology | 1700 N.broad St., 2nd Foor, Philadelphia, PA 19121 | 2015-03-24 |
| 1285986828 | Young Scholars Frederick Douglass Charter School | Local Education Agency (LEA) | 2118 W Norris St., Philadelphia, PA 19121 | 2012-10-05 |
| 1568764470 | Young Scholars Frederick Douglass Charter School | Local Education Agency (LEA) | 2118 W Norris St, Philadelphia, PA 19121 | 2010-11-29 |
| 1730408683 | Pamela Lewis | Registered Nurse | Serenity Court, 1221 N. 19th St., Philadelphia, PA 19121 | 2010-05-18 |
| Find all providers in zip 19121 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770199341 | Nicole Kassandra Carissimi | Nurse Practitioner | 1618 S 19th St, Philadelphia, PA 19145-1439 | 2020-09-19 |
| 1770192775 | Lisa Ghiloni | Nurse Practitioner | 6809 N 10th St, Philadelphia, PA 19126-2906 | 2020-07-26 |
| 1104440940 | Patricia Cecilia Castillo | Nurse Practitioner | 49204 Delaire Landing Rd, Philadelphia, PA 19114-5329 | 2020-06-06 |
| 1184271074 | Clement John | Nurse Practitioner | 3253 N 6th St, Philadelphia, PA 19140-5644 | 2019-08-25 |
| 1558915967 | Latoya Mohammed | Nurse Practitioner | 3300 Henry Ave Ste 3n, Philadelphia, PA 19129-1141 | 2019-07-25 |
| 1225427867 | Alison Ercole | Nurse Practitioner | 4301 Spruce St, Apt A 414, Philadelphia, PA 19104-4760 | 2015-01-20 |
| 1790195386 | Thomasean Britten | Nurse Practitioner | 449 Parker Ave, Philadelphia, PA 19128-4403 | 2014-05-05 |
| 1891048377 | Elizabeth Ann Milburn | Nurse Practitioner | 1528 Walnut St Ste 1414, Philadelphia, PA 19102-3610 | 2012-10-20 |
| 1336410851 | Justin Egoville | Nurse Practitioner | 80001 State Rd., Mhm Correctional Services, Mod II, Philadelphia, PA 19136-0000 | 2012-01-13 |
| 1396050720 | Dwayne M Toomer | Nurse Practitioner | 718 Addison St Apt E, Philadelphia, PA 19147-1353 | 2010-08-10 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19121 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.