State of Delaware

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

1047 Issued in DE

Legal business name

STATE OF DELAWARE

Practice address

26351 Patriots Way
Georgetown, DE 19947-2575

Phone

(302) 933-3000

Fax

(302) 934-1376

NPI assigned

Jan 25, 2007

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

Ms. Valerie J. Smith

Title

Chief of Administration

Phone

(302) 744-9600

Specialties & licenses 1

Addresses

Other names 1

• General Practice Stockley Center Other name

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

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

• State of de

  dba NC Community Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wilmington, DE
  • NPI 1609895762

  O20040319000575

  Same enrollment
• State of Delaware

  dba Kent/Sussex Community Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dover, DE
  • NPI 1104871920

  O20040319000575

  Same enrollment
• State of Delaware

  • Skilled Nursing Facility
  • Smyrna, DE
  • NPI 1538123583

  O20040319000575

  Same enrollment
• State of Delaware

  • Clinical Medical Laboratory
  • Dover, DE
  • NPI 1922170703

  O20040319000575

  Same enrollment

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558417683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26351 PATRIOTS WAY",
            "city": "GEORGETOWN",
            "state": "DE",
            "postal_code": "199472575",
            "telephone_number": "302-933-3000",
            "fax_number": "302-934-1376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26351 PATRIOTS WAY",
            "city": "GEORGETOWN",
            "state": "DE",
            "postal_code": "199472575",
            "telephone_number": "302-933-3000",
            "fax_number": "302-934-1376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF DELAWARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CHIEF OF ADMINISTRATION",
        "authorized_official_telephone_number": "302-744-9600",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "DE",
            "license": "1047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "General Practice Stockley Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Southern Delaware Sportscare and Rehabilitation, LLC (Pivot Physical Therapy)
• Anna Sparrow, PTA
• Hayley A Sprague, O.D.
• Lisa Staab, CRNP
• Jessica Stag, OTR/L
• State of Delaware (Sussex Technical School District)
• State of Delaware-DDDS As.Liv
• State of Delaware-Stockley
• Steady Steps Physical Therapy
• David Stewart, FNP-C PMHNP-BC

• Intellectual Disabilities Intermediate Care Facility in Georgetown, DE
• Providers in Georgetown, DE by specialty
• Intellectual Disabilities Intermediate Care Facility 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.
• 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.