Individual provider Active NPI

Emma Kubik, NNP

  • Neonatal Nurse Practitioner
  • Newark, DE
National Provider Identifier
1093307696
Registry record updated Nov 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
LM-0010179 Issued in DE
Practice address
4745 Ogletown Stanton Rd Ste 217
Newark, DE 19713-2074
Phone
(302) 733-2410
Fax
(302) 733-2602
NPI assigned
Feb 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X L1-0054031 DE
Neonatal Nurse Practitioner 363LN0000X LM-0010179 DE Primary

Addresses

Primary practice location

4745 Ogletown Stanton Rd Ste 217
Newark, DE 19713-2074

Mailing address

4745 Ogletown Stanton Rd Ste 217
Newark, DE 19713-2074
Phone (302) 733-2410

Other names 1

  • Emma Killion Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210310002048 DE Order and Referring Only - Nurse Practitioner 8729494059

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L1-0054031DEMDRegistered Nurse
LM-0010179DEMDNeonatal Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700784000000",
    "number": "1093307696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4745 OGLETOWN STANTON RD STE 217",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132074",
            "telephone_number": "302-733-2410",
            "fax_number": "302-733-2602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 OGLETOWN STANTON RD STE 217",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132074",
            "telephone_number": "302-733-2410",
            "fax_number": "302-733-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBIK",
        "first_name": "EMMA",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-05",
        "last_updated": "2023-11-24",
        "certification_date": "2023-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DE",
            "license": "L1-0054031",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "DE",
            "license": "LM-0010179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMMA",
            "last_name": "KILLION",
            "credential": "NNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.