NPIMap

Organization Active NPI

Delaware Womens Imaging LLC

  • Diagnostic Radiology Physician
  • Newark, DE
National Provider Identifier
1720172885
Registry record updated Dec 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2006602488 Issued in DE
Legal business name
DELAWARE WOMENS IMAGING LLC
Practice address
J-24 Omega Drive
Newark, DE 19713
Phone
(302) 738-9100
Fax
(302) 739-9748
NPI assigned
Oct 3, 2006
Organization subpart
Yes
Parent organization
DIA PRACTICE ENTERPRISES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 20, 2012

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

Authorized official

Name
Victoria L Peacock, MS, MS
Title
Project Manager
Phone
(302) 993-2330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X 2006602488 DE Primary

Addresses

Primary practice location

J-24 Omega Drive
Newark, DE 19713

Mailing address

1601 Milltown Rd
Suite 13
Wilmington, DE 19808-4027
Phone (302) 993-2330

Other identifiers 2

IdentifierTypeStateIssuer
0000632802MedicaidDE
2006602488OtherDELICENSE NUMBER

Other names 1

  • Womens Imaging Center of Delaware Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355961600000",
    "number": "1720172885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 MILLTOWN RD",
            "address_2": "SUITE 13",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198084027",
            "telephone_number": "302-993-2330",
            "fax_number": "302-993-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "J-24 OMEGA DRIVE",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19713",
            "telephone_number": "302-738-9100",
            "fax_number": "302-739-9748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAWARE WOMENS IMAGING LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIA PRACTICE ENTERPRISES LLC",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-12-20",
        "status": "A",
        "authorized_official_last_name": "PEACOCK",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PROJECT MANAGER",
        "authorized_official_telephone_number": "302-993-2330",
        "authorized_official_credential": "MS, MS"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "DE",
            "license": "2006602488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000632802",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "2006602488",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Womens Imaging Center of Delaware",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.