Active NPI
Derek Eckenrode
- Registered Nurse
- Lewes, DE
National Provider Identifier
1003204082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R180751
- Practice address
- 424 Savannah Rd
Lewes, DE 19958-1462 - Phone
- (302) 645-3300
- NPI assigned
- Dec 29, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R180751 | MD | Primary |
Addresses
Primary practice location
424 Savannah Rd
Lewes, DE 19958-1462
Mailing address
129 Elizabeth Way
South Bethany, DE 19930-9667
Phone (443) 956-7031
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R180751 | MD | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419811200000",
"number": "1003204082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "129 ELIZABETH WAY",
"city": "SOUTH BETHANY",
"state": "DE",
"postal_code": "199309667",
"telephone_number": "443-956-7031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 SAVANNAH RD",
"city": "LEWES",
"state": "DE",
"postal_code": "199581462",
"telephone_number": "302-645-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ECKENRODE",
"first_name": "DEREK",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-12-29",
"last_updated": "2014-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MD",
"license": "R180751",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewes, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.