NPIMap

Organization Active NPI

Foundation Medical Services PA

  • Family Medicine Physician
  • Dover, DE
National Provider Identifier
1710249537
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C2-0005927 Issued in DE
Legal business name
FOUNDATION MEDICAL SERVICES PA
Practice address
230 Beiser Blvd
Suite 101
Dover, DE 19904-7793
Phone
(302) 730-1101
NPI assigned
Jun 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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

Authorized official

Name
Michael Gondolfo, DC
Title
President
Phone
(302) 730-1101

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X F1-0000323 DE
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X C2-0005927 DE Primary

Addresses

Primary practice location

230 Beiser Blvd
Suite 101
Dover, DE 19904-7793

Mailing address

230 Beiser Blvd
Suite 101
Dover, DE 19904-7793
Phone (302) 730-1101

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351123200000",
    "number": "1710249537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 BEISER BLVD",
            "address_2": "SUITE 101",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199047793",
            "telephone_number": "302-730-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 BEISER BLVD",
            "address_2": "SUITE 101",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199047793",
            "telephone_number": "302-730-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATION MEDICAL SERVICES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-08",
        "last_updated": "2012-10-25",
        "status": "A",
        "authorized_official_last_name": "GONDOLFO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "302-730-1101",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "DE",
            "license": "F1-0000323",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C2-0005927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; 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.