NPIMap

Organization Active NPI

State of Delaware

  • State or Local Public Health Clinic/Center
  • Dover, DE
National Provider Identifier
1013082171
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
Legal business name
STATE OF DELAWARE
Practice address
417 Federal St
Dover, DE 19901-3635
Phone
(302) 744-4548
Fax
(302) 739-1613
NPI assigned
Nov 22, 2006
Last updated
Dec 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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

Authorized official

Name
Karyl Rattay, MDNPI 1124216585
Title
Director
Phone
(302) 744-4700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
State or Local Public Health Clinic/Center 261QP0905X NU Primary

Addresses

Primary practice location

417 Federal St
Dover, DE 19901-3635

Mailing address

417 Federal St
Dover, DE 19901-3635
Phone (302) 744-4548

Other identifiers 1

IdentifierTypeStateIssuer
0000121149MedicaidDE

Other names 1

  • Kent EPSDT Other name

National Provider Directory

National Provider Directory
Tax ID family
Psychiatry Delaware Sta131 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

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

View all 15

Practitioners & affiliated clinicians

Practitioners 1

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": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323129600000",
    "number": "1013082171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 FEDERAL ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013635",
            "telephone_number": "302-744-4548",
            "fax_number": "302-739-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 FEDERAL ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013635",
            "telephone_number": "302-744-4548",
            "fax_number": "302-739-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF DELAWARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2011-12-06",
        "status": "A",
        "authorized_official_last_name": "RATTAY",
        "authorized_official_first_name": "KARYL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "302-744-4700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000121149",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kent EPSDT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dover, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.