Active NPI
Delvin Charleston
- Land Ambulance
- Sicklerville, NJ
National Provider Identifier
1245657246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 100694
- Practice address
- 17 Madison LN
Sicklerville, NJ 08081-4410 - Phone
- (856) 875-2273
- Fax
- (856) 875-2275
- NPI assigned
- Mar 27, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 100694 | NJ | Primary |
| Non-emergency Medical Transport (VAN) | 343900000X | 100694 | NJ |
Addresses
Primary practice location
17 Madison LN
Sicklerville, NJ 08081-4410
Mailing address
17 Madison LN
Sicklerville, NJ 08081-4410
Phone (856) 875-2273
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100694 | NJ | MD | Land Ambulance |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Care Medical Transport LLC | Land Transport | Past | Accepting new patients |
| Premiaer Care Medical Transport | Land Transport | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395878400000",
"number": "1245657246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 MADISON LN",
"city": "SICKLERVILLE",
"state": "NJ",
"postal_code": "080814410",
"telephone_number": "856-875-2273",
"fax_number": "856-875-2275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 MADISON LN",
"city": "SICKLERVILLE",
"state": "NJ",
"postal_code": "080814410",
"telephone_number": "856-875-2273",
"fax_number": "856-875-2275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARLESTON",
"first_name": "DELVIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-03-27",
"last_updated": "2014-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "NJ",
"license": "100694",
"primary": true
},
{
"code": "343900000X",
"taxonomy_group": "",
"desc": "Non-emergency Medical Transport (VAN)",
"state": "NJ",
"license": "100694",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sicklerville, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.