Organization Active NPI

La Red Health Center, Inc.

Doing business as Seaford GYN Associates

  • Federally Qualified Health Center (FQHC)
  • Seaford, DE
National Provider Identifier
1740653922
Registry record updated Apr 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LA RED HEALTH CENTER, INC.
Doing business as
Seaford GYN Associates
Practice address
105 N Front St Ste B
Seaford, DE 19973-2707
Phone
(302) 855-1233
Fax
(302) 855-2025
NPI assigned
Nov 10, 2015
Last updated
Apr 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2016

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

Authorized official

Name
Mr. Brian S Olson
Title
Ceo
Phone
(302) 855-1233

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Primary Care Clinic/Center 261QP2300X NU

Addresses

Primary practice location

105 N Front St Ste B
Seaford, DE 19973-2707

Mailing address

21444 Carmean Way
Georgetown, DE 19947-4572
Phone (302) 855-1233

Other names 1

  • Seaford GYN Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070306000183 DE Part B Supplier - Clinic/Group Practice 4789668815 Receives reassigned benefits from 32 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Georgetown, DE; Seaford, DE; Milford, DE

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

105 N Front St
#B
Seaford, DE 19973
Phone (302) 629-2434

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461542400000",
    "number": "1740653922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21444 CARMEAN WAY",
            "city": "GEORGETOWN",
            "state": "DE",
            "postal_code": "199474572",
            "telephone_number": "302-855-1233",
            "fax_number": "302-855-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N FRONT ST STE B",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199732707",
            "telephone_number": "302-855-1233",
            "fax_number": "302-855-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA RED HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-10",
        "last_updated": "2016-04-25",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "302-855-1233",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seaford GYN Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seaford, DE

Sources for this page

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