State of Delaware

Primary specialty

Student Health Clinic/CenterTaxonomy code 261QS1000X

Legal business name

STATE OF DELAWARE

Practice address

417 Federal St
Dover, DE 19901-3635

Phone

(302) 744-4849

Fax

(302) 739-6627

NPI assigned

Dec 5, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Herman Ellis, MD

Title

Medical Director

Phone

(302) 744-4700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sussex Tech Wellness Center Other name

Tax ID family

Psychiatry Delaware Sta131 organizations share this tax ID, including this one

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.

• Delaware Academy Public Safety and Security

  • Local Education Agency (LEA)
  • New Castle, DE
  • NPI 1558793117
  NPD tax ID
• Delaware Early Childhood Center

  • Local Education Agency (LEA)
  • Harrington, DE
  • NPI 1376687244
  NPD tax ID
• Delaware Psychiatric Center Pharmacy

  • Institutional Pharmacy
  • New Castle, DE
  • NPI 1467493312
  NPD tax ID
• Division of Substance Abuse and Mental Health

  dba Kent Bridge Clinic

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Dover, DE
  • NPI 1487365854
  NPD tax ID
• New Castle Community Mental Health Pharmacy

  • Community/Retail Pharmacy
  • Wilmington, DE
  • NPI 1518912427
  NPD tax ID
• State of Delaware

  dba Polytech School District

  • Local Education Agency (LEA)
  • Woodside, DE
  • NPI 1326185547
  NPD tax ID
• State of Delaware

  • Student Health Clinic/Center
  • Dover, DE
  • NPI 1346318755
  NPD tax ID
• State of Delaware

  dba MOT Charter School

  • Local Education Agency (LEA)
  • Middletown, DE
  • NPI 1346384260
  NPD tax ID
• State of Delaware

  dba Caesar Rodney School District

  • Local Education Agency (LEA)
  • Camden, DE
  • NPI 1376687087
  NPD tax ID
• State of Delaware

  • Student Health Clinic/Center
  • Dover, DE
  • NPI 1386712792
  NPD tax ID
• State of Delaware

  dba Laurel School District

  • Local Education Agency (LEA)
  • Laurel, DE
  • NPI 1386788255
  NPD tax ID
• State of Delaware

  • State or Local Public Health Clinic/Center
  • Dover, DE
  • NPI 1407935661
  NPD tax ID

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477611895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 FEDERAL ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013635",
            "telephone_number": "302-744-4849",
            "fax_number": "302-739-6627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 FEDERAL ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013635",
            "telephone_number": "302-744-4849",
            "fax_number": "302-739-6627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF DELAWARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "HERMAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "302-744-4700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000013809",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sussex Tech Wellness Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• State of Delaware
• State of Delaware
• State of Delaware
• State of Delaware
• State of Delaware
• State of Delaware
• State of Delaware
• State of Delaware
• State of Delaware
• State of Delaware

• Student Health Clinic/Center in Dover, DE
• Providers in Dover, DE by specialty
• Student Health Clinic/Center in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.