Active NPI
M Lynne Dupont, MD
- Pediatrics Physician
- Wilmington, DE
National Provider Identifier
1609890219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- C10005471
- Practice address
- 910 Foulk Road
Suite 101
Wilmington, DE 19803-3157 - Phone
- (302) 655-3242
- Fax
- (302) 655-5392
- NPI assigned
- Jul 27, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | C10005471 | DE | Primary |
| Pediatrics Physician | 208000000X | MD067350L | PA | |
| General Practice Physician | 208D00000X | C10005471 | DE |
Addresses
Primary practice location
910 Foulk Road
Suite 101
Wilmington, DE 19803-3157
Mailing address
PO Box 191
Provider Enrollment Dept
Rockland, DE 19732-0191
Phone (302) 651-6212
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000958201 | Medicaid | DE | |
| 0133345 | Medicaid | NJ | |
| 101960506 | Medicaid | PA | |
| 412689100 | Medicaid | MD |
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 |
|---|---|---|---|
| MD067350L | PA | MD | Pediatrics Physician |
| C10005471 | DE | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324944000000",
"number": "1609890219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 191",
"address_2": "PROVIDER ENROLLMENT DEPT",
"city": "ROCKLAND",
"state": "DE",
"postal_code": "197320191",
"telephone_number": "302-651-6212",
"fax_number": "302-651-4945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "910 FOULK ROAD",
"address_2": "SUITE 101",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198033157",
"telephone_number": "302-655-3242",
"fax_number": "302-655-5392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUPONT",
"first_name": "M",
"middle_name": "LYNNE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-27",
"last_updated": "2011-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "DE",
"license": "C10005471",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD067350L",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "DE",
"license": "C10005471",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000958201",
"state": "DE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0133345",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101960506",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "412689100",
"state": "MD"
}
],
"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 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.