Organization Active NPI

Delaware Injury Care L.L.C.

  • Chiropractor
  • Dover, DE
National Provider Identifier
1073646907
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
F1-0000623 Issued in DE
Legal business name
DELAWARE INJURY CARE L.L.C.
Practice address
240 Beiser Blvd Ste 101
Dover, DE 19904-8208
Phone
(302) 678-8866
Fax
(866) 378-9982
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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

Authorized official

Name
Edwin JusteNPI 1558494385
Title
Member
Phone
(914) 960-1145

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X F1-0000623 DE Primary

Addresses

Primary practice location

240 Beiser Blvd Ste 101
Dover, DE 19904-8208

Mailing address

4023 Kennett Pike # 620
Wilmington, DE 19807-2018
Phone (914) 960-1145

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090403000130 DE Part B Supplier - Clinic/Group Practice 3577610856 Receives reassigned benefits from 3 practitioners
Practice locations: Dover, DE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555459200000",
    "number": "1073646907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4023 KENNETT PIKE # 620",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198072018",
            "telephone_number": "914-960-1145",
            "fax_number": "866-378-9982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 BEISER BLVD STE 101",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199048208",
            "telephone_number": "302-678-8866",
            "fax_number": "866-378-9982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAWARE INJURY CARE L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2019-04-17",
        "status": "A",
        "authorized_official_last_name": "JUSTE",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "914-960-1145"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "DE",
            "license": "F1-0000623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 17, 2019; 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.

Verify at the official NPI Registry.