Individual provider Active NPI

John V. Fenice, M.D.

  • Family Medicine Physician
  • Wilmington, DE
National Provider Identifier
1033138169
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C1-0007714 Issued in DE
Practice address
2601 Annand Dr
Suite 4
Wilmington, DE 19808-3719
Phone
(302) 998-3334
Fax
(302) 998-8985
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MA79983 NJ
Family Medicine Physician 207Q00000X C1-0007714 DE Primary

Addresses

Primary practice location

2601 Annand Dr
Suite 4
Wilmington, DE 19808-3719

Mailing address

2601 Annand Dr
Suite 4
Wilmington, DE 19808-3719
Phone (302) 998-3334

Other practice location 1

1114 S DuPont Hwy
Dover, DE 19901-4401
Phone (833) 886-2277

Other identifiers 4

IdentifierTypeStateIssuer
222137644OtherNJBCBSNJ
900000011100OtherNJAMERICHOICE
222137644OtherNJCHAMPUS/TRICARE
0091111MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060130000666 DE Practitioner - Family PracticePractitioner - Podiatry 9537173786 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Podiatry
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2601 Annand Dr
Wilmington, DE 19808-3719
Phone (302) 998-3334

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue12
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA79983NJMDEmergency Medicine Physician
C1-0007714DEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lotus Recovery Center of Prices Corner CurrentSince Mar 17, 2022 Accepting new patients
Img Associates LLC CurrentSince Dec 27, 2016 Accepting new patients
Heritage Medical Associates, P.a. Family Medicine CurrentSince Jul 13, 2007 Accepting new patients
Connections Community Support Programs, Inc. Family Medicine Past Accepting new patients
Eps Billing, LLC Past Accepting new patients
Emergency Physician Services LLC Emergency Medicine Past Accepting new patients

Locations

2601 Annand Dr
Ste 4
Wilmington, DE 19808
Phone (302) 998-3334

1812 Newport Gap Pike
Wilmington, DE 19808
Phone (302) 500-5997

701 Foulk Rd
Ste 2E
Wilmington, DE 19803
Phone (302) 765-2345

10996 Four Seasons Pl
Ste 100A
Crown Point, IN 46307
Phone (219) 213-2380

1100 Business Pkwy S
Ste 1
Westminster, MD 21157

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/1e751165-d0f5-47ed-aa9b-1a8abb55d1d6/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1033138169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 ANNAND DR",
            "address_2": "SUITE 4",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198083719",
            "telephone_number": "302-998-3334",
            "fax_number": "302-998-8985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 ANNAND DR",
            "address_2": "SUITE 4",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198083719",
            "telephone_number": "302-998-3334",
            "fax_number": "302-998-8985"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1114 S DuPont Hwy",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "DE",
            "postal_code": "199014401",
            "country_code": "US",
            "telephone_number": "833-886-2277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FENICE",
        "first_name": "JOHN",
        "middle_name": "V.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "MA79983",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C1-0007714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNJ",
            "identifier": "222137644",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "900000011100",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS/TRICARE",
            "identifier": "222137644",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0091111",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.