Christiana Care Health Services, Inc
Organization Active NPI Family Medicine Physician · Wilmington, DE
NPI 1619951068 · NPPES record last updated Dec 17, 2021
Key facts
- NPI
- 1619951068
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- CHRISTIANA CARE HEALTH SERVICES, INC
- Practice address
- 1401 Foulk Rd
Suite 100B
Wilmington, DE 19803-2763 - Phone
- (302) 477-3300
- Fax
- (302) 477-3168
- NPI assigned
- Nov 30, 2005
- Organization subpart
- Yes
- Parent organization (as reported)
- CHRISTIANA CARE HEALTH SERVICES, INC
Authorized official
- Name
- Robert W McMurray Jr.
- Title
- Cfo
- Phone
- (302) 428-2522
Other NPIs on the same Medicare enrollment 32
Practitioners 64
-
Adrienne Emma Abrenica, CRNP
-
Karen J Antell, MD
-
David M Bercaw, MD
-
Rooparani M Bhat, M.D.
-
Evan Dodge Bilheimer, M.D., MPH
-
Aaron R Block, P.A.-C
-
Jordan J. Cohen, DO
-
Valerie Ann Cohen, D.O.
-
Audrey J Collins, GNP
-
Seema Bipin Dattani, M.D.
-
Cherie Lynn Demerchant, NP-C
-
Wayne Andrew Duffus, M.D.
-
Anna B. Filip, MD
-
Olivia Gad, D.O.
-
Alyssa M Hancock, NP
-
Elise C Hogan, MD, MPH
-
Annie Elizabeth Ingram, NP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031201000477 | DE | Part B Supplier - Clinic/Group Practice | 9739097569 |
Receives reassigned benefits from 1,678 practitioners 32 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
- Part of
- Christiana Care Ambulance
Locations
1080 Bunker Hill Rd
Middletown, DE 19709
Phone (302) 378-5960
111 Continental Dr
Newark, DE 19713
Phone (302) 368-2630
4755 Ogletown Stanton Rd
#6E88
Newark, DE 19718
Phone (302) 733-4186
301 McKennans Church Rd
Wilmington, DE 19808
Phone (302) 636-5330
501 W 14th St
Bldg 5
Wilmington, DE 19801
1401 Foulk Rd
Ste 100
Wilmington, DE 19803
Phone (267) 975-2199
5201 Washington Street Ext
Wilmington, DE 19809
Phone (302) 765-1100
1400 N Washington St
Ste 325
Wilmington, DE 19801
205 W 14th St
Ste 100A
Wilmington, DE 19801
Phone (302) 320-2620
1400 N Washington St
Rm 327
Wilmington, DE 19801
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Adolescent Medicine (Family Medicine) Physician |
207QA0000X | |||
| Geriatric Medicine (Family Medicine) Physician |
207QG0300X | |||
| Sports Medicine (Family Medicine) Physician |
207QS0010X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
1401 Foulk Rd
Suite 100B
Wilmington, DE 19803-2763
Mailing address
PO Box 30170
Wilmington, DE 19805-7170
Other practice location 1
1400 N Washington St Ste 300
Wilmington, DE 19801-1024
Phone (302) 255-1220
Other practice location 2
501 W 14th St
Wilmington, DE 19801-1013
Phone (302) 477-3300
Other practice location 3
400 South St Ste 100
New Castle, DE 19720-5057
Phone (302) 327-7630
Other practice location 4
365 Airport Rd
New Castle, DE 19720-1007
Phone (302) 320-9660
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619951068 | Medicaid | DE |
Other names
- CCHS Family Medicine
NPI Registry JSON
{
"created_epoch": "1133308800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1639699200000",
"number": "1619951068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 30170",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198057170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 FOULK RD",
"address_2": "SUITE 100B",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198032763",
"telephone_number": "302-477-3300",
"fax_number": "302-477-3168"
}
],
"practiceLocations": [
{
"address_1": "1400 N Washington St Ste 300",
"address_purpose": "LOCATION",
"city": "Wilmington",
"state": "DE",
"postal_code": "198011024",
"country_code": "US",
"telephone_number": "302-255-1220",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "501 W 14th St",
"address_purpose": "LOCATION",
"city": "Wilmington",
"state": "DE",
"postal_code": "198011013",
"country_code": "US",
"telephone_number": "302-477-3300",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "400 South St Ste 100",
"address_purpose": "LOCATION",
"city": "New Castle",
"state": "DE",
"postal_code": "197205057",
"country_code": "US",
"telephone_number": "302-327-7630",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "365 Airport Rd",
"address_purpose": "LOCATION",
"city": "New Castle",
"state": "DE",
"postal_code": "197201007",
"country_code": "US",
"telephone_number": "302-320-9660",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "CHRISTIANA CARE HEALTH SERVICES, INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CHRISTIANA CARE HEALTH SERVICES, INC",
"enumeration_date": "2005-11-30",
"last_updated": "2021-12-17",
"certification_date": "2021-12-17",
"status": "A",
"authorized_official_last_name": "MCMURRAY",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "302-428-2522",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207QA0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Adolescent Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207QG0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Geriatric Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207QS0010X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Sports Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1619951068",
"state": "DE"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CCHS Family Medicine",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "CCHS Family Medicine",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Wilmington, DE
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All providers in Wilmington, DE · Family Medicine Physician in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.