Individual provider Active NPI

Ginna Elizabeth Keil, CRNP

  • Nurse Practitioner
  • Newark, DE
National Provider Identifier
1104461763
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
LG-0001348 Issued in DE
Practice address
16 Polly Drummond SHPG Ctr Ste 2
Newark, DE 19711-4861
Phone
(302) 478-5707
Fax
(302) 478-1351
NPI assigned
Nov 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LG-0001348 DE
Nurse Practitioner 363L00000X LG-0001348 DE Primary

Addresses

Primary practice location

16 Polly Drummond SHPG Ctr Ste 2
Newark, DE 19711-4861

Mailing address

21202 Bayview Rd
Rehoboth Beach, DE 19971

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
I20200701001698 DE Practitioner - Nurse Practitioner 8820412257 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Patient Care Medical Group Delaware LLCGroup PAC ID 6002352432, 2 clinicians

Practice addresses (Care Compare)

36101 Seaside Blvd
Rehoboth Beach, DE 19971-1147
Phone (609) 521-4746

Hospital & facility affiliations

  • Aveanna Home Healthcare Home health agency, Milford, DE, CCN 087039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
LG-0001348DEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Hospice, Inc CurrentSince Mar 31, 2020 Accepting new patients
Patient Care Medical Group Delaware LLC Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
Signify Health, LLC Nurse Practitioner CurrentSince Jun 1, 2024 Accepting new patients
Delaware Hospice, Inc Family Medicine PastSince Nov 10, 2019 Accepting new patients
Delaware Hospice, Inc. Family Medicine PastSince Nov 10, 2019 Accepting new patients

Locations

630 Churchmans Rd
Ste 200
Newark, DE 19702
Phone (302) 478-5707

1209 N Orange St
Wilmington, DE 19801
Phone (800) 875-1575

26 Main St
Edison, NJ 08837
Phone (609) 385-2622

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 5

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 1

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": "1573084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1104461763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21202 BAYVIEW RD",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "19971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 POLLY DRUMMOND SHPG CTR STE 2",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197114861",
            "telephone_number": "302-478-5707",
            "fax_number": "302-478-1351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEIL",
        "first_name": "GINNA",
        "middle_name": "ELIZABETH",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-07",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "LG-0001348",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG-0001348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.