NPIMap

Organization Active NPI

State of Delaware Department of Public Heath Access Program Telehealth

  • General Practice Physician
  • Dover, DE
National Provider Identifier
1073330379
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
STATE OF DELAWARE DEPARTMENT OF PUBLIC HEATH ACCESS PROGRAM TELEHEALTH
Practice address
417 Federal Street
Dover, DE 19901
Phone
(302) 744-4700
Fax
(302) 744-5361
NPI assigned
Sep 26, 2024
Last updated
Sep 26, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
DE DPH CARE ACCESS TELEHEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Authorized official

Name
Olubusola Ogunlade, M.D.
Title
Chief Physician Division of Public
Phone
(302) 730-2941

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X
Obstetrics & Gynecology Physician 207V00000X
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

417 Federal Street
Dover, DE 19901

Mailing address

417 Federal Street
Dover, DE 19901
Phone (302) 744-4700

Other identifiers 1

IdentifierTypeStateIssuer
1013089895MedicaidDE

Other names 1

  • Care Access Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
Fernhook Mental Hygiene131 organizations share this tax ID, including this one
Part of
Fernhook Mental Hygiene

Organizations with this tax ID in the same state 21

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

View all 21

Locations

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

NPI Registry JSON

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

{
    "created_epoch": "1727308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1073330379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 FEDERAL STREET",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "19901",
            "telephone_number": "302-744-4700",
            "fax_number": "302-744-5361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 FEDERAL STREET",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "19901",
            "telephone_number": "302-744-4700",
            "fax_number": "302-744-5361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF DELAWARE DEPARTMENT OF PUBLIC HEATH ACCESS PROGRAM TELEHEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DE DPH CARE ACCESS TELEHEALTH",
        "enumeration_date": "2024-09-26",
        "last_updated": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "OGUNLADE",
        "authorized_official_first_name": "OLUBUSOLA",
        "authorized_official_title_or_position": "CHIEF PHYSICIAN DIVISION OF PUBLIC",
        "authorized_official_telephone_number": "302-730-2941",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013089895",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Care Access Clinic",
            "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 Sep 26, 2024; 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.