Wilmington Vamc

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

LG-0000180 Issued in DE

Legal business name

WILMINGTON VAMC

Practice address

1601 Kirkwood Hwy
Wilmington, DE 19805-4917

Phone

(302) 994-2511

Fax

(302) 633-5339

NPI assigned

Apr 11, 2014

Last updated

Apr 11, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Bernardine Catherine Henderson, NP

Title

Diabetes Nurse Practitioner

Phone

(302) 994-2511

Specialties & licenses 1

Addresses

Tax ID family

Navy Medical Branch Clinic - Uk200 organizations share this tax ID, including this one

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

{
    "created_epoch": "1397174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397174400000",
    "number": "1346669850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 KIRKWOOD HWY",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198054917",
            "telephone_number": "302-994-2511",
            "fax_number": "302-633-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 KIRKWOOD HWY",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198054917",
            "telephone_number": "302-994-2511",
            "fax_number": "302-633-5339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILMINGTON VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-11",
        "last_updated": "2014-04-11",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "BERNARDINE",
        "authorized_official_middle_name": "CATHERINE",
        "authorized_official_title_or_position": "DIABETES NURSE PRACTITIONER",
        "authorized_official_telephone_number": "302-994-2511",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "DE",
            "license": "LG-0000180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wilmington Physical Therapy & Wellness
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• Wilmington Vamc
• Wilmington Vamc
• Wilmington Vamc
• Wilmington-Appaloosa LLC (Family Dental Center)
• Thomas Bruce Wilmoth II, PA-C
• Niyhosi Wilson-Butts, SOBER LIVING PROGRAM

• Health Service Clinic/Center in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Health Service Clinic/Center in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2014; 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.