Active NPI
Davenshire Medical Center Partnership
- Family Medicine Physician
- Dover, PA
National Provider Identifier
1023040490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- DAVENSHIRE MEDICAL CENTER PARTNERSHIP
- Practice address
- 3740 Carlisle Rd
Dover, PA 17315-4416 - Phone
- (717) 292-3168
- Fax
- (717) 292-3479
- NPI assigned
- Jul 7, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robin Terry
- Title
- Office Manager
- Phone
- (717) 292-3168
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
3740 Carlisle Rd
Dover, PA 17315-4416
Mailing address
3740 Carlisle Rd
Dover, PA 17315-4416
Phone (717) 292-3168
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040505001237 | PA | Part B Supplier - Clinic/Group Practice | 2062400187 |
Receives reassigned benefits from 4 practitioners Practice locations: Dover, PA |
National Provider Directory
National Provider Directory- Tax ID family
- Davenshire Medical Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Primary Care Clinic/Center
- Dover, PA
- NPI 1730517350
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1208476800000",
"number": "1023040490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3740 CARLISLE RD",
"city": "DOVER",
"state": "PA",
"postal_code": "173154416",
"telephone_number": "717-292-3168",
"fax_number": "717-292-3479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3740 CARLISLE RD",
"city": "DOVER",
"state": "PA",
"postal_code": "173154416",
"telephone_number": "717-292-3168",
"fax_number": "717-292-3479"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DAVENSHIRE MEDICAL CENTER PARTNERSHIP",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-07",
"last_updated": "2008-04-18",
"status": "A",
"authorized_official_last_name": "TERRY",
"authorized_official_first_name": "ROBIN",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "717-292-3168"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dover, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; 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.