Organization Active NPI

Psychiatry Delaware Company LLC

  • Forensic Psychiatry Physician
  • Wilmington, DE
National Provider Identifier
1316329261
Registry record updated Sep 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic Psychiatry PhysicianTaxonomy code 2084F0202X
License
C20007931 Issued in DE
Legal business name
PSYCHIATRY DELAWARE COMPANY LLC
Practice address
1415 Foulk Rd Ste 104
Foulkstone Plaza
Wilmington, DE 19803-2748
Phone
(302) 478-1450
Fax
(302) 478-1430
NPI assigned
Jun 26, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2015

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

Authorized official

Name
Andrew W Donohue, D.O.NPI 1346237559
Title
Owner
Phone
(302) 478-1450

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084F0202X C20007931 DE Primary

Addresses

Primary practice location

1415 Foulk Rd Ste 104
Foulkstone Plaza
Wilmington, DE 19803-2748

Mailing address

1415 Foulk Rd Ste 104
Foulkstone Plaza
Wilmington, DE 19803-2748
Phone (302) 478-1450

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150915000157 DE Part B Supplier - Clinic/Group Practice 6204143878 Receives reassigned benefits from 10 practitioners
Practice locations: Wilmington, DE

National Provider Directory

National Provider Directory

Locations

1415 Foulk Rd
Ste 104
Wilmington, DE 19803
Phone (302) 478-1450

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1435276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441670400000",
    "number": "1316329261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 FOULK RD STE 104",
            "address_2": "FOULKSTONE PLAZA",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198032748",
            "telephone_number": "302-478-1450",
            "fax_number": "302-478-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 FOULK RD STE 104",
            "address_2": "FOULKSTONE PLAZA",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198032748",
            "telephone_number": "302-478-1450",
            "fax_number": "302-478-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRY DELAWARE COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-26",
        "last_updated": "2015-09-08",
        "status": "A",
        "authorized_official_last_name": "DONOHUE",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-478-1450",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "DE",
            "license": "C20007931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 8, 2015; 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.