Active NPI
Judith Carol Wollman, MD
- Family Medicine Physician
- Wilmington, DE
National Provider Identifier
1447242474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- C10001849
- Practice address
- 1401 Foulk Road
Suite 202
Wilmington, DE 19803-2764 - Phone
- (302) 478-5650
- Fax
- (302) 477-0455
- NPI assigned
- Aug 16, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | C10001849 | DE | Primary |
Addresses
Primary practice location
1401 Foulk Road
Suite 202
Wilmington, DE 19803-2764
Mailing address
1401 Foulk Road
Suite 202
Wilmington, DE 19803-2764
Phone (302) 478-5650
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C10001849 | DE | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KLC Support Services, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Professional Counselor
- Montchanin, DE
- NPI 1215301494
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388361600000",
"number": "1447242474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 FOULK ROAD",
"address_2": "SUITE 202",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198032764",
"telephone_number": "302-478-5650",
"fax_number": "302-477-0455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 FOULK ROAD",
"address_2": "SUITE 202",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198032764",
"telephone_number": "302-478-5650",
"fax_number": "302-477-0455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLLMAN",
"first_name": "JUDITH",
"middle_name": "CAROL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-16",
"last_updated": "2013-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "DE",
"license": "C10001849",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Dec 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.