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JUSTIN EGOVILLE NP NPI 1336410851


NPI Information

NPI: 1336410851
Provider Name: JUSTIN EGOVILLE, NP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Organization: CODAC HEALTH RECOVERY AND WELLNESS

PECOS Registration: Yes

Address:
80001 STATE RD.
MHM CORRECTIONAL SERVICES, MOD II
PHILADELPHIA, PA
ZIP 19136
Phone: (215) 624-0797
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Justin Egoville, NP is a psychiatric/mental health nurse practitioner in Philadelphia, PA with 14 years of experience. Justin Egoville, NP NPI is 1336410851. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

80001 STATE RD.
MHM CORRECTIONAL SERVICES, MOD II
PHILADELPHIA, PA
ZIP 19136-000
Phone: (215) 624-0797

The NPI 1336410851 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Psychiatric diagnostic evaluation with medical services (HCPCS:90792)

The enumeration date for this NPI number is 1/13/2012 and was last updated on 1/13/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthSP011762PENNSYLVANIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.