NPIMap

Organization Active NPI

Christiana Care Health Services Inc

Doing business as CCHS Diabetes & Metabolic

  • Endocrinology, Diabetes & Metabolism Physician
  • Wilmington, DE
National Provider Identifier
1407830748
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
CHRISTIANA CARE HEALTH SERVICES INC
Doing business as
CCHS Diabetes & Metabolic
Practice address
3506 Kennett Pike
Wilmington, DE 19807-3019
Phone
(302) 661-3070
Fax
(302) 066-1308
NPI assigned
Nov 30, 2005
Last updated
Sep 29, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
CHRISTIANA CARE HEALTH SERVICES INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Authorized official

Name
Mr. Robert W McMurray Jr.
Title
Cfo
Phone
(302) 428-2522

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NU
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU Primary
Nurse Practitioner 363L00000X NU
Adult Health Nurse Practitioner 363LA2200X NU
Family Nurse Practitioner 363LF0000X NU

Addresses

Primary practice location

3506 Kennett Pike
Wilmington, DE 19807-3019

Mailing address

PO Box 30170
Wilmington, DE 19805-7170
Phone (302) 623-7019

Other practice location 1

501 W 14th St Fl 4
Wilmington, DE 19801-1013
Phone (302) 623-3475

Other practice location 2

4735 Ogletown Stanton Rd Ste 3201
Newark, DE 19713-2094
Phone (302) 623-4323

Other practice location 3

4735 Ogletown Stanton Rd Ste 1211
Newark, DE 19713-2089
Phone (302) 623-3053

Other practice location 4

300 Biddle Ave Ste 201
Newark, DE 19702-3972
Phone (302) 661-3070

Other identifiers 1

IdentifierTypeStateIssuer
1407830748MedicaidDE

Other names 1

  • CCHS Diabetes & Metabolic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031201000477 DE Part B Supplier - Clinic/Group Practice 9739097569 Receives reassigned benefits from 1,678 practitioners
32 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 32

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 32

National Provider Directory

National Provider Directory
Tax ID family
Medical Ctr of Delaware104 organizations share this tax ID, including this one
Part of
Medical Ctr of Delaware

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

4735 Ogletown Stanton Rd
Ste 1211
Newark, DE 19713
Phone (302) 623-3053

501 W 14th St
#4
Wilmington, DE 19801
Phone (302) 661-3070

501 W 14th St
Fl 4
Wilmington, DE 19801
Phone (302) 623-3475

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664409600000",
    "number": "1407830748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30170",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198057170",
            "telephone_number": "302-623-7019",
            "fax_number": "302-623-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3506 KENNETT PIKE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198073019",
            "telephone_number": "302-661-3070",
            "fax_number": "302-066-1308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 W 14th St Fl 4",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198011013",
            "country_code": "US",
            "telephone_number": "302-623-3475",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4735 Ogletown Stanton Rd Ste 3201",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197132094",
            "country_code": "US",
            "telephone_number": "302-623-4323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4735 Ogletown Stanton Rd Ste 1211",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197132089",
            "country_code": "US",
            "telephone_number": "302-623-3053",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Biddle Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197023972",
            "country_code": "US",
            "telephone_number": "302-661-3070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHRISTIANA CARE HEALTH SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHRISTIANA CARE HEALTH SERVICES INC.",
        "enumeration_date": "2005-11-30",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A",
        "authorized_official_last_name": "MCMURRAY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "302-428-2522",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407830748",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCHS Diabetes & Metabolic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CCHS Diabetes & Metabolic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 29, 2022; 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.