Lighthouse Complex Care of Delaware Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

LIGHTHOUSE COMPLEX CARE OF DELAWARE INC

Practice address

2500 Grubb Rd Ste 123
Wilmington, DE 19810-4711

Phone

(302) 304-3417

Fax

(302) 467-2474

NPI assigned

Nov 23, 2022

Last updated

Apr 2, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Meera Manickam

Title

Owner

Phone

(302) 740-1347

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in DE, PA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

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.

• Monica Cooke, APRN

  • Family Nurse Practitioner
  • Wilmington, DE
  • NPI 1699379784

  PA

  Medicare reassignment Care Compare group NPD
• Dane R Fliedner, MD

  • Pediatrics Physician
  • Wilmington, DE
  • NPI 1164568655

  PA

  Medicare reassignment Care Compare group NPD
• Jill Erwin, FNP-BC

  • Family Nurse Practitioner
  • Elkton, MD
  • NPI 1548986821

  DE

  Medicare reassignment Care Compare group NPD
• Kathleen McEwen, CRNP

  • Family Nurse Practitioner
  • Monroeville, PA
  • NPI 1902827454

  DE

  Medicare reassignment NPD
• Sapna Reshma Muragali, M.D.

  • Family Medicine Physician
  • Hellertown, PA
  • NPI 1881973279

  DE

  Medicare reassignment NPD
• Jacqueline Rita Kelly, CRNP

  • Pediatric Nurse Practitioner
  • Baltimore, MD
  • NPI 1366203036

  DE

  Medicare reassignment

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

{
    "created_epoch": "1669161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1720797251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 GRUBB RD STE 123",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104711",
            "telephone_number": "302-304-3417",
            "fax_number": "302-467-2474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 GRUBB RD STE 123",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104711",
            "telephone_number": "302-304-3417",
            "fax_number": "302-467-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE COMPLEX CARE OF DELAWARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-23",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "MANICKAM",
        "authorized_official_first_name": "MEERA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-740-1347"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifemd New England Patient Medical Care PA
• Lifespan Counseling at the Kids Couch Inc LLC
• Lifestream Behavioral Health
• Irwin Lance Lifrak, M.D.
• Elizabeth Juanita Liggett
• Lighthouse Therapeutic Mentoring & Counseling Services, LLC
• Marianne Theresa Liles, NPC
• Amanda M Lilly, RN
• Doyle J Lim, M.D.
• Limen House, Inc (Limen Recovery and Wellness)

• Multi-Specialty Clinic/Center in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Multi-Specialty Clinic/Center in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.