NPIMap

Organization Active NPI

Christiana Care Health Services Inc

Doing business as CCHS Sports Medicine

  • Sports Medicine (Family Medicine) Physician
  • Wilmington, DE
National Provider Identifier
1003844028
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
Legal business name
CHRISTIANA CARE HEALTH SERVICES INC
Doing business as
CCHS Sports Medicine
Practice address
3506 Kennett Pike
Wilmington, DE 19807-3019
Phone
(302) 661-3000
Fax
(302) 661-3470
NPI assigned
Jun 29, 2006
Last updated
Feb 11, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
CHRISTIANA CARE HEALTH SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Authorized official

Name
Robert W McMurray Jr.
Title
Cfo
Phone
(302) 428-2522

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X Primary

Addresses

Primary practice location

3506 Kennett Pike
Wilmington, DE 19807-3019

Mailing address

PO Box 30170
Wilmington, DE 19805-7170
Phone (302) 623-7362

Other practice location 1

621 Middletown Odessa Rd Fl 2
Middletown, DE 19709-9602
Phone (302) 320-9440

Other practice location 2

501 W 14th St
Wilmington, DE 19801-1013
Phone (302) 320-9440

Other practice location 3

300 Biddle Ave Ste 200
Newark, DE 19702-3972
Phone (302) 320-9440

Other practice location 4

1401 Foulk Rd Ste 100B
Wilmington, DE 19803-2764
Phone (302) 320-9440

Other practice location 5

200 Hygeia Dr Ste 1360
Newark, DE 19713-2049
Phone (302) 320-9440

Other identifiers 1

IdentifierTypeStateIssuer
1003844028MedicaidDE

Other names 1

  • CCHS Sports Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031201000477 DE Part B Supplier - Clinic/Group Practice 9739097569 Receives reassigned benefits from 1,678 practitioners
32 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 32

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 32

National Provider Directory

National Provider Directory
Tax ID family
Dept of Surgery104 organizations share this tax ID, including this one
Part of
Dept of Surgery

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

1400 N Washington St
Fl 3
Wilmington, DE 19801
Phone (302) 255-1358

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644537600000",
    "number": "1003844028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30170",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198057170",
            "telephone_number": "302-623-7362",
            "fax_number": "302-623-7374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3506 KENNETT PIKE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198073019",
            "telephone_number": "302-661-3000",
            "fax_number": "302-661-3470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "621 Middletown Odessa Rd Fl 2",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "DE",
            "postal_code": "197099602",
            "country_code": "US",
            "telephone_number": "302-320-9440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 W 14th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198011013",
            "country_code": "US",
            "telephone_number": "302-320-9440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Biddle Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197023972",
            "country_code": "US",
            "telephone_number": "302-320-9440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1401 Foulk Rd Ste 100B",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198032764",
            "country_code": "US",
            "telephone_number": "302-320-9440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Hygeia Dr Ste 1360",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197132049",
            "country_code": "US",
            "telephone_number": "302-320-9440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHRISTIANA CARE HEALTH SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHRISTIANA CARE HEALTH SERVICES INC",
        "enumeration_date": "2006-06-29",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A",
        "authorized_official_last_name": "MCMURRAY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "302-428-2522",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003844028",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCHS Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CCHS Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.