Individual provider Active NPI

Amanda J. Shillingford, MD

  • Pediatric Cardiology Physician
  • Wilmington, DE
National Provider Identifier
1326167347
Registry record updated Apr 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
C10011178 Issued in DE
Practice address
1600 Rockland Rd
Wilmington, DE 19803-3607
Phone
(302) 651-4200
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X C10011178 DE Primary
Pediatrics Physician 208000000X MD419577 PA
Pediatric Cardiology Physician 2080P0202X MD419577 PA
Pediatric Cardiology Physician 2080P0202X 52053 WI

Addresses

Primary practice location

1600 Rockland Rd
Wilmington, DE 19803-3607

Mailing address

P.O. Box 191
Rockland, DE 19723-0191
Phone (302) 651-4000

Other identifiers 1

IdentifierTypeStateIssuer
1326167347MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150209001472 DE Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 6204921190 Reassigns benefits to 1 organization
I20160429000046 NJ Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 6204921190 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD419577PAMDPediatrics Physician
C10011178DEMDPediatric Cardiology Physician
52053WIMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nemours New Jersey Physician Practice, P.C. Pediatrics CurrentSince Sep 2, 2018 Accepting new patients
The Nemours Foundation CurrentSince Feb 1, 2015 Accepting new patients
Cooper Pediatric Specialists, PC Pediatrics CurrentSince Apr 1, 2016 Accepting new patients
The Nemours Foundation CurrentSince Feb 1, 2015 Accepting new patients
Childrens Health Care Associates of New Jersey PC Pediatrics Past Accepting new patients
Childrens Hospital of Philadelphia Past Accepting new patients

Locations

1600 Rockland Rd
Wilmington, DE 19803

3 Cooper Plz
Rm 200
Camden, NJ 08103
Phone (609) 342-2001

1280 Almonesson Rd
Woodbury, NJ 08096
Phone (856) 345-1401

Organizations & group practices 6

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": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461542400000",
    "number": "1326167347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 191",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197230191",
            "telephone_number": "302-651-4000",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ROCKLAND RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033607",
            "telephone_number": "302-651-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHILLINGFORD",
        "first_name": "AMANDA",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2016-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "DE",
            "license": "C10011178",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD419577",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "PA",
            "license": "MD419577",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "WI",
            "license": "52053",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326167347",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.