State of Delaware

Primary specialty

Student Health Clinic/CenterTaxonomy code 261QS1000X

Legal business name

STATE OF DELAWARE

Practice address

417 Federal St
Dover, DE 19901-3635

Phone

(302) 744-4849

Fax

(302) 739-6627

NPI assigned

Dec 1, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Herman Ellis, MD

Title

Medical Director

Phone

(302) 744-4700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Seaford Wellness Center Other name

Tax ID family

Psychiatry Delaware Sta131 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

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

• Dental Health Center of del-Tech

  • Dental Clinic/Center
  • Wilmington, DE
  • NPI 1114057825
  NPD tax ID
• State of de

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New Castle, DE
  • NPI 1104582816
  NPD tax ID
• State of Delaware

  • Student Health Clinic/Center
  • Dover, DE
  • NPI 1003984410
  NPD tax ID
• State of Delaware

  • State or Local Public Health Clinic/Center
  • Dover, DE
  • NPI 1003995267
  NPD tax ID
• State of Delaware

  dba Campus Community Charter School

  • Local Education Agency (LEA)
  • Dover, DE
  • NPI 1013051986
  NPD tax ID
• State of Delaware

  • State or Local Public Health Clinic/Center
  • Dover, DE
  • NPI 1013082171
  NPD tax ID
• State of Delaware

  • Public Health or Welfare Agency
  • Dover, DE
  • NPI 1013089895
  NPD tax ID
• State of Delaware

  dba Cape Henlopen School District

  • Local Education Agency (LEA)
  • Lewes, DE
  • NPI 1023152998
  NPD tax ID
• State of Delaware

  • State or Local Public Health Clinic/Center
  • Dover, DE
  • NPI 1033298294
  NPD tax ID
• State of Delaware

  • State or Local Public Health Clinic/Center
  • Dover, DE
  • NPI 1043385404
  NPD tax ID
• State of Delaware

  dba Seaford School District

  • Local Education Agency (LEA)
  • Seaford, DE
  • NPI 1093859704
  NPD tax ID
• State of Delaware

  • Local Education Agency (LEA)
  • Dover, DE
  • NPI 1104960079
  NPD tax ID

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063580470",
    "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": "302-744-4849",
            "fax_number": "302-739-6627"
        },
        {
            "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": "302-739-6627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF DELAWARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "HERMAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "302-744-4700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000013817",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seaford Wellness Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• State of Delaware (Campus Community Charter School)
• State of Delaware
• State of Delaware
• State of Delaware
• State of Delaware
• State of Delaware (Kent/Sussex Community Mental Health Center)
• State of Delaware
• State of Delaware
• State of Delaware
• State of Delaware

• Student Health Clinic/Center in Dover, DE
• Providers in Dover, DE by specialty
• Student Health Clinic/Center in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.