NPIMap

Organization Active NPI

State of Delaware

  • Public Health or Welfare Agency
  • Dover, DE
National Provider Identifier
1013089895
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
STATE OF DELAWARE
Practice address
417 Federal St
Dover, DE 19901-3635
Phone
(302) 744-4849
Fax
(302) 739-1613
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Authorized official

Name
Gary Alston Owens II
Title
Fiscal Manager
Phone
(302) 744-4861

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary
Dental Clinic/Center 261QD0000X

Addresses

Primary practice location

417 Federal St
Dover, DE 19901-3635

Mailing address

417 Federal St
Dover, DE 19901-3635
Phone (302) 744-4861

Other identifiers 1

IdentifierTypeStateIssuer
0000117554MedicaidDE

Other names 1

  • Division of Public Health Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241016001309 DE Part B Supplier - Clinic/Group Practice 6507756731 Receives reassigned benefits from 1 practitioner
Practice locations: Dover, DE

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
DVH Dental Suite131 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

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

View all 16

Locations

546 S Bedford St
#M
Georgetown, DE 19947
Phone (302) 856-5490

501 Ogletown Rd
Newark, DE 19711
Phone (302) 283-7530

258 Chapman Rd
Ste 100
Newark, DE 19702
Phone (302) 283-7164

3000 Newport Gap Pike
#P
Wilmington, DE 19808
Phone (302) 995-8400

3000 Newport Gap Pike
Wilmington, DE 19808
Phone (302) 995-8400

1906 Maryland Ave
#M
Wilmington, DE 19805
Phone (302) 778-6900

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Delaware Hospital F/T Chronically IllSmyrna, DE, CCN 085035 Skilled nursing facility Adp of the SNF
Indirect Ownership Interest (1%)		 Sep 1, 1983
Sep 1, 1983

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772668800000",
    "number": "1013089895",
    "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": "302-744-4861",
            "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": "302-744-4849",
            "fax_number": "302-739-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF DELAWARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "ALSTON",
        "authorized_official_title_or_position": "FISCAL MANAGER",
        "authorized_official_telephone_number": "302-744-4861",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000117554",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Division of Public Health",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Division of Public Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.