Organization Active NPI

Rheumatology Center of Delaware, LLC

  • Rheumatology Physician
  • Dover, DE
National Provider Identifier
1447308168
Registry record updated May 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
C10005894 Issued in DE
Legal business name
RHEUMATOLOGY CENTER OF DELAWARE, LLC
Practice address
260 Beiser Blvd Ste 201
Dover, DE 19904-7790
Phone
(302) 678-7438
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2011

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

Authorized official

Name
Penny Shockley
Title
Office Manager
Phone
(302) 678-7438

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X C10005894 DE Primary

Addresses

Primary practice location

260 Beiser Blvd Ste 201
Dover, DE 19904-7790

Mailing address

260 Beiser Blvd Ste 201
Dover, DE 19904-7790
Phone (302) 678-7438

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070525000185 DE Part B Supplier - Clinic/Group Practice 2163529199 Receives reassigned benefits from 2 practitioners
Practice locations: Dover, DE; Milford, DE; Wilmington, DE

National Provider Directory

National Provider Directory

Locations

874 Walker Rd
Ste B
Dover, DE 19904
Phone (302) 632-8381

260 Beiser Blvd
Ste 201
Dover, DE 19904
Phone (302) 678-7438

2000 Brent Jordan Way
Ste 201
Milford, DE 19963

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306454400000",
    "number": "1447308168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 BEISER BLVD STE 201",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199047790",
            "telephone_number": "302-678-7438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 BEISER BLVD STE 201",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199047790",
            "telephone_number": "302-678-7438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RHEUMATOLOGY CENTER OF DELAWARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2011-05-27",
        "status": "A",
        "authorized_official_last_name": "SHOCKLEY",
        "authorized_official_first_name": "PENNY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "302-678-7438"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "DE",
            "license": "C10005894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2011; 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.