Individual provider Active NPI

Elizabeth Gichema

  • Psychiatric/Mental Health Nurse Practitioner
  • Wilmington, DE
National Provider Identifier
1356860167
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
LG-0001063 Issued in DE
Practice address
1601 Milltown Rd
Wilmington, DE 19808-4027
Phone
(302) 543-6165
NPI assigned
Sep 12, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X LG-0001063 DE Primary

Addresses

Primary practice location

1601 Milltown Rd
Wilmington, DE 19808-4027

Mailing address

802 Village Cir Apt D
Newark, DE 19713-4901
Phone (302) 252-8498

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171024002845 DE Practitioner - Nurse Practitioner 7214203975 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
LG-0001063DEMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Imperial Psychiatric Services LLC Psychiatric/Mental Health CurrentSince Jan 1, 2021 Accepting new patients
Mindvisory LLC CurrentSince Apr 8, 2022 Accepting new patients
Geriatric Medicine Consultants PA CurrentSince Oct 1, 2017 Accepting new patients
Vista Medical Services, Inc. CurrentSince Sep 1, 2021 Accepting new patients
Tri-State Health, Inc. Nurse Practitioner Past Accepting new patients
Your Center, LLC Past Accepting new patients

Locations

379 Walmart Dr
Camden, DE 19934
Phone (302) 387-4343

231 S Washington St
Millsboro, DE 19966
Phone (302) 645-4664

5651 Limestone Rd
Wilmington, DE 19808
Phone (302) 239-8583

810 S Broom St
Wilmington, DE 19805
Phone (302) 234-5420

1601 Milltown Rd
Ste 2
Wilmington, DE 19808
Phone (302) 463-6542

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": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1356860167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 VILLAGE CIR APT D",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197134901",
            "telephone_number": "302-252-8498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 MILLTOWN RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198084027",
            "telephone_number": "302-543-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GICHEMA",
        "first_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-12",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DE",
            "license": "LG-0001063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.