NPIMap

Organization Active NPI

Delaware Pain & Spine Center, Inc.

  • Specialist
  • Wilmington, DE
National Provider Identifier
1720106230
Registry record updated Mar 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
C1-0004306 Issued in DE
Legal business name
DELAWARE PAIN & SPINE CENTER, INC.
Practice address
2055 Limestone Rd
Suite 201
Wilmington, DE 19808-5536
Phone
(302) 737-0800
Fax
(302) 738-4914
NPI assigned
Mar 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2016

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

Authorized official

Name
Dr. Uday S Uthaman, M.D.NPI 1871661041
Title
President
Phone
(302) 444-8169

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X C1-0004306 DE Primary

Addresses

Primary practice location

2055 Limestone Rd
Suite 201
Wilmington, DE 19808-5536

Mailing address

PO Box 8252
Newark, DE 19714-8252
Phone (302) 737-0800

Other identifiers 1

IdentifierTypeStateIssuer
0000561501MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110915000606 DE DME Supplier - Physician - Interventional Pain Management 6002087442 Practice locations: Wilmington, DE
O20120224000184 DE Part B Supplier - Clinic/Group Practice 6002087442 Receives reassigned benefits from 1 practitioner
Practice locations: Wilmington, DE

National Provider Directory

National Provider Directory

Locations

2055 Limestone Rd
Ste 201
Wilmington, DE 19808
Phone (302) 737-0800

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457481600000",
    "number": "1720106230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8252",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197148252",
            "telephone_number": "302-737-0800",
            "fax_number": "302-738-4914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 LIMESTONE RD",
            "address_2": "SUITE 201",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198085536",
            "telephone_number": "302-737-0800",
            "fax_number": "302-738-4914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAWARE PAIN & SPINE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2016-03-09",
        "status": "A",
        "authorized_official_last_name": "UTHAMAN",
        "authorized_official_first_name": "UDAY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "302-444-8169",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "DE",
            "license": "C1-0004306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000561501",
            "state": "DE"
        }
    ],
    "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 Mar 9, 2016; 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.