NPIMap

Organization Active NPI

Medexpress, Inc - Delaware

Doing business as MedExpress - Wilmington Concord Pike

  • Family Medicine Physician
  • Wilmington, DE
National Provider Identifier
1255692182
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDEXPRESS, INC - DELAWARE
Doing business as
MedExpress - Wilmington Concord Pike
Practice address
2722 Concord Pike
Wilmington, DE 19803-5007
Phone
(302) 477-1406
Fax
(302) 477-1495
NPI assigned
Jun 7, 2012
Last updated
May 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Authorized official

Name
Joy Kimball
Title
Contract Manager
Phone
(763) 349-6740

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
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 names 1

  • MedExpress - Wilmington Concord Pike Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2722 Concord Pike
Wilmington, DE 19803
Phone (302) 477-1406

Practitioners & affiliated clinicians

Practitioners 112

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.

View all 112

NPI Registry JSON

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1255692182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 FORTRESS BLVD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081351",
            "telephone_number": "304-225-2500",
            "fax_number": "304-985-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2722 CONCORD PIKE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198035007",
            "telephone_number": "302-477-1406",
            "fax_number": "302-477-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDEXPRESS, INC - DELAWARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-07",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "KIMBALL",
        "authorized_official_first_name": "JOY",
        "authorized_official_title_or_position": "CONTRACT MANAGER",
        "authorized_official_telephone_number": "763-349-6740"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedExpress - Wilmington Concord Pike",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.