Organization Active NPI

Rehabilitation Associates, P.a.

Doing business as Delaware Back Pain & Sports Rehabilitation Centers

  • Physical Medicine & Rehabilitation Physician
  • Wilmington, DE
National Provider Identifier
1679509160
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
REHABILITATION ASSOCIATES, P.A.
Doing business as
Delaware Back Pain & Sports Rehabilitation Centers
Practice address
2006 Foulk Rd
Suite B
Wilmington, DE 19810-3644
Phone
(302) 529-8783
Fax
(302) 529-1586
NPI assigned
Jun 25, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Victoria Wollaston
Title
Credentialing Specialist
Phone
(302) 529-8783

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X DE Primary

Addresses

Primary practice location

2006 Foulk Rd
Suite B
Wilmington, DE 19810-3644

Mailing address

200 Biddle Ave, Springside
Suite 204
Newark, DE 19702-3968
Phone (302) 529-8783

Other identifiers 9

IdentifierTypeStateIssuer
1595337OtherDEAMERIHEALTH
386606954CHIOtherDEBC/BS-CHIRO
0632730OtherDEAETNA HMO
147504MedicaidDE
386606954OtherDEBLUE CROSS/BLUE SHIELD
26774OtherDECOVENTRY
5707129OtherDEAETNA PPO
CC5686OtherDERAILROAD MEDICARE
2272852000OtherDEAMERIHEATH-KEYSTONE

Other names 1

  • Delaware Back Pain & Sports Rehabilitation Centers Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040519000159 DE Part B Supplier - Clinic/Group Practice 7416948526 Receives reassigned benefits from 16 practitioners
Practice locations: Wilmington, DE; Smyrna, DE; Newark, DE; Milford, DE; Dover, DE

National Provider Directory

National Provider Directory
Tax ID family
Delaware Back Pain Sports Rehabilitation Centers3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1006 College Rd
Ste 201
Dover, DE 19904
Phone (302) 730-4907

915 N DuPont Blvd
Ste 104
Milford, DE 19963
Phone (302) 491-4487

200 Biddle Ave
Ste 204
Newark, DE 19702
Phone (302) 832-3369

87 Omega Dr
#B
Newark, DE 19713
Phone (302) 733-0980

700 W Lea Blvd
Ste 102
Wilmington, DE 19802
Phone (302) 764-0271

6681 Ridge Rd
Ste 404
Parma, OH 44129
Phone (216) 888-3200

6688 Ridge Rd
Ste 404
Parma, OH 44129
Phone (216) 888-3200

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1679509160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BIDDLE AVE, SPRINGSIDE",
            "address_2": "SUITE 204",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197023968",
            "telephone_number": "302-529-8783",
            "fax_number": "302-529-1586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 FOULK RD",
            "address_2": "SUITE B",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198103644",
            "telephone_number": "302-529-8783",
            "fax_number": "302-529-1586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABILITATION ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WOLLASTON",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "302-529-8783"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "DE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "1595337",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS-CHIRO",
            "identifier": "386606954CHI",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "0632730",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147504",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "386606954",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "26774",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "5707129",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC5686",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEATH-KEYSTONE",
            "identifier": "2272852000",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Delaware Back Pain & Sports Rehabilitation Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 21, 2022; 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.