Delaware Integrative Healthcare LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

DELAWARE INTEGRATIVE HEALTHCARE LLC

Practice address

421 E Main St Ste 6
Middletown, DE 19709-1463

Phone

(302) 376-5830

Fax

(302) 376-6517

NPI assigned

Dec 18, 2018

Last updated

Aug 25, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Trevor Kent Ennis, DCNPI 1316198005

Title

Owner/President

Phone

(302) 376-5830

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DE2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 15

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.

• Trevor Kent Ennis, D.C.

  • Rehabilitation Chiropractor
  • Middletown, DE
  • NPI 1316198005

  Multi-Specialty

  Medicare reassignment Care Compare group NPD Authorized official
• Kristina Renee Borcky, MSN, FNP-C, OCN

  • Family Nurse Practitioner
  • Middletown, DE
  • NPI 1194405837
  Medicare reassignment Care Compare group NPD
• Philip Richard Brown, D.C

  • Chiropractor
  • Middletown, DE
  • NPI 1831636190
  Medicare reassignment Care Compare group NPD
• Ryan Ross, DC

  • Chiropractor
  • Newark, DE
  • NPI 1770247207
  Medicare reassignment Care Compare group NPD
• Shakira N Lee, D.C.

  • Chiropractor
  • Suwanee, GA
  • NPI 1831550300

  DE

  Medicare reassignment Care Compare group NPD
• Kirk C Evans, D.C.

  • Chiropractor
  • Smyrna, DE
  • NPI 1942329354
  Medicare reassignment NPD
• Colton Ross Gervais

  • Chiropractor
  • Dover, DE
  • NPI 1710652185
  Medicare reassignment NPD
• Rebecca Keeley, D.C.

  • Chiropractor
  • Wilmington, DE
  • NPI 1508016536
  Medicare reassignment NPD
• Nicole Sheree Lee, CRNP

  • Family Nurse Practitioner
  • Lewes, DE
  • NPI 1730302233
  Medicare reassignment NPD
• Dallas L Mastin, FNP-BC FNP-C

  • Family Nurse Practitioner
  • Milford, DE
  • NPI 1255929022
  Medicare reassignment NPD
• Julie E Morley, NP

  • Family Nurse Practitioner
  • Middletown, DE
  • NPI 1164877825
  Medicare reassignment NPD
• Juewuo Arthur Quest Reeves, DC

  • Chiropractor
  • Middletown, DE
  • NPI 1134741002
  Medicare reassignment NPD

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

{
    "created_epoch": "1545091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629849600000",
    "number": "1225500093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 E MAIN ST STE 6",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197091463",
            "telephone_number": "302-376-5830",
            "fax_number": "302-376-6517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 E MAIN ST STE 6",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197091463",
            "telephone_number": "302-376-5830",
            "fax_number": "302-376-6517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 S DuPont Hwy Ste 203",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "DE",
            "postal_code": "199013798",
            "country_code": "US",
            "telephone_number": "302-744-8650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "272 Carter Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "DE",
            "postal_code": "197095850",
            "country_code": "US",
            "telephone_number": "302-378-5110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DELAWARE INTEGRATIVE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-18",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A",
        "authorized_official_last_name": "ENNIS",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "302-376-5830",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Delaware Health and Social Services
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• Delaware Ophthalmology Consultants PA (DOC Optical Center)
• Delaware Sleep Disorder Centers, LLC
• Delaware Sleep Disorder Centers, LLC

• General Practice Physician in Middletown, DE
• Providers in Middletown, DE by specialty
• General Practice Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.