Southern Delaware Surgery Center

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

FSSC-012 Issued in DE

Legal business name

SOUTHERN DELAWARE SURGERY CENTER

Practice address

18941 John J Williams Hwy
Rehoboth Beach, DE 19971-4404

Phone

(302) 644-6992

Fax

(302) 644-6995

NPI assigned

Oct 26, 2005

Organization subpart

No

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

Authorized official

Name

Marti Potter, RN,CNOR,MHCA

Title

Administrator

Phone

(302) 644-6992

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212710400000",
    "number": "1295725711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18941 JOHN J WILLIAMS HWY",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199714404",
            "telephone_number": "302-644-6992",
            "fax_number": "302-644-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18941 JOHN J WILLIAMS HWY",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199714404",
            "telephone_number": "302-644-6992",
            "fax_number": "302-644-6995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DELAWARE SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-26",
        "last_updated": "2008-06-06",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "MARTI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "302-644-6992",
        "authorized_official_credential": "RN,CNOR,MHCA"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "DE",
            "license": "FSSC-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "165A61",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000034296",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Smith
• Ryan T. Sod
• Michael David Sofronski, M.D.
• Southern Delaware Associates of Dental Specialities
• Southern Delaware Sportscare and Rehabilitation, LLC
• Linda Jean Spaulding, RN
• Lauren Speakman
• James E. Spellman Jr., MD
• James Peter Spillane, DPT
• Shantel Nicole Spittle, CNA

• Multi-Specialty Clinic/Center in Rehoboth Beach, DE
• Providers in Rehoboth Beach, DE by specialty
• Multi-Specialty Clinic/Center in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.