Organization Active NPI

Georgetown Family Medicine

  • Family Medicine Physician
  • Georgetown, DE
National Provider Identifier
1225173149
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C2-0006045 Issued in DE
Legal business name
GEORGETOWN FAMILY MEDICINE
Practice address
201 W Market St
Georgetown, DE 19947-1440
Phone
(302) 856-3171
Fax
(302) 856-2330
NPI assigned
Feb 20, 2007
Last updated
Sep 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Authorized official

Name
Ryan Scot Davis
Title
Office Manager
Phone
(785) 341-4569

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C5-00000702 DE
Family Medicine Physician 207Q00000X C2-0006044 DE
Family Medicine Physician 207Q00000X C2-0006045 DE Primary

Addresses

Primary practice location

201 W Market St
Georgetown, DE 19947-1440

Mailing address

201 W Market St
Georgetown, DE 19947-1440
Phone (785) 341-4569

Other identifiers 2

IdentifierTypeStateIssuer
G00438OtherDEPETAN
0001044304MedicaidDE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040726000726 DE Part B Supplier - Clinic/Group Practice 8123008471 Receives reassigned benefits from 2 practitioners
Practice locations: Georgetown, DE

National Provider Directory

National Provider Directory

Locations

201 W Market St
Georgetown, DE 19947
Phone (302) 856-2254

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757030400000",
    "number": "1225173149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W MARKET ST",
            "city": "GEORGETOWN",
            "state": "DE",
            "postal_code": "199471440",
            "telephone_number": "785-341-4569",
            "fax_number": "302-856-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W MARKET ST",
            "city": "GEORGETOWN",
            "state": "DE",
            "postal_code": "199471440",
            "telephone_number": "302-856-3171",
            "fax_number": "302-856-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGETOWN FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "SCOT",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "785-341-4569"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-00000702",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C2-0006044",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C2-0006045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PETAN",
            "identifier": "G00438",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001044304",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; 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.