Medexpress, Inc - Delaware
Organization Active NPI Family Medicine Physician · Wilmington, DE
NPI 1255692182 · NPPES record last updated May 7, 2024
Key facts
- NPI
- 1255692182
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- MEDEXPRESS, INC - DELAWARE
- Practice address
- 2722 Concord Pike
Wilmington, DE 19803-5007 - Phone
- (302) 477-1406
- Fax
- (302) 477-1495
- NPI assigned
- Jun 7, 2012
- Organization subpart
- No
Authorized official
- Name
- Joy Kimball
- Title
- Contract Manager
- Phone
- (763) 349-6740
Other NPIs on the same Medicare enrollment 4
Practitioners 112
-
Hema Murali Gouru, M.D.
-
Lynnanne Kasarda, MD
-
Latanya Keyes, APRN
-
Lisa Ann Martin, D.O.
-
Stephen Patrick Ogden, D.O.
-
Johnita Tiller, APRN
-
Alicia Camille Vogleson, APRN, FNP-BC
-
Jing Wei, MD
-
Hillel Wirsztel, MD
-
Jeena Mary Zachariah, M.D
-
Melanie Margaret Alexander, MSN, APRN, FNP-C
-
Marek T Didluch, M.D.
-
Michael V Dimucci, RN, MSN, FNP-C
-
Linda Eld, CRNP
-
Paula Kay Fontenote, ANP
-
Danita Renelsa Fox, M.D.
-
Sandra Sue Jones, FNP-BC
-
Brittany N Mertz, PA-C
-
Akita Miller-Abbey, FNP
-
Michael J Richards, CRNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120808000579 | DE | Part B Supplier - Clinic/Group Practice | 5294981163 |
Receives reassigned benefits from 34 practitioners 4 other NPIs on this enrollment Practice locations: Newark, DE; Wilmington, DE; New Castle, DE; Dover, DE |
National Provider Directory
Locations
2722 Concord Pike
Wilmington, DE 19803
Phone (302) 477-1406
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Emergency Care Clinic/Center | 261QE0002X |
Addresses
Primary practice location
2722 Concord Pike
Wilmington, DE 19803-5007
Mailing address
423 Fortress Blvd
Morgantown, WV 26508-1351
Phone (304) 225-2500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255692182 | Medicaid | DE |
Other names
- MedExpress - Wilmington Concord Pike
Other providers in Wilmington, DE
- Zachary Mease
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- Medallion Home Care of de LLC
- Medeval, Corp.
- Medexpress, Inc - Delaware
- William L. Medford
- Medical Massage of Delaware
- Medical Massage of Delaware
- Linda Medio
- Medisphere Solution Inc
All providers in Wilmington, DE · Family Medicine Physician in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.