Individual provider Active NPI

Martin Chukwugozie Banks

  • Internal Medicine Physician
  • Dover, DE
National Provider Identifier
1356101125
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
207R00000X Issued in DE
Practice address
640 S State St
Dover, DE 19901-3530
Phone
(302) 674-4700
NPI assigned
Mar 20, 2024
Last updated
Apr 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 207R00000X DE Primary

Addresses

Primary practice location

640 S State St
Dover, DE 19901-3530

Mailing address

640 S State St
Dover, DE 19901-3530
Phone (302) 744-6274

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL securerecords.sanford.html

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240404003857 DE Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 7214375575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
207R00000XDEMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1356101125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-744-6274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-674-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS",
        "first_name": "MARTIN",
        "middle_name": "CHUKWUGOZIE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-20",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "207R00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "securerecords.sanford.html",
            "affiliation": "N",
            "address_1": "640 S State St",
            "city": "Dover",
            "state": "DE",
            "country_code": "US",
            "postal_code": "199013530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.