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Christiana Care Health Services, Inc

Organization Active NPI Endocrinology, Diabetes & Metabolism Physician · Wilmington, DE

NPI 1770568107 · NPPES record last updated Dec 17, 2021

Key facts

NPI
1770568107
Entity type
Organization (NPI type 2)
Primary specialty
Endocrinology, Diabetes & Metabolism Physician 207RE0101X
Legal business name
CHRISTIANA CARE HEALTH SERVICES, INC
Practice address
3506 Kennett Pike
Pmri
Wilmington, DE 19807-3019
Phone
(302) 661-3000
Fax
(302) 661-3470
NPI assigned
Dec 8, 2005
Organization subpart
Yes
Parent organization (as reported)
CHRISTIANA CARE HEALTH SERVICES, INC

Authorized official

Name
Robert W McMurray Jr.
Title
Cfo
Phone
(302) 428-2522

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 32

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

View all 32

Other NPIs with the same Medicare PAC ID 24

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 2,092

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

View all 2,092

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in DE

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Union Hospital of Cecil County
Elkton, MD · CCN 210032		 Hospital 5% Or Greater Direct Ownership Interest (50%)
Operational/Managerial Control (100%)		 Jan 1, 2020
Jan 1, 2020
Christianacare Hospital, West Grove
West Grove, PA · CCN 390431		 Hospital 5% Or Greater Indirect Ownership Interest (51%) Oct 9, 2023
Christianacare Homehealth
Smyrna, DE · CCN 087301		 Home health agency Operational/Managerial Control (100%) Jul 1, 2021
Christianacare-Accentcare Hospice & Palliative Care of Delaware
Newark, DE · CCN 081508		 Hospice 5% Or Greater Direct Ownership Interest (40%) Jun 1, 2021

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031201000477 DE Part B Supplier - Clinic/Group Practice 9739097569 Receives reassigned benefits from 1,678 practitioners
32 other NPIs on this enrollment
O20180713002646 DE MDPP Supplier - in-Person MDPP Supplier 9739097569 Practice locations: Newark, DE; Wilmington, DE

National Provider Directory

Tax ID family
Christiana Care Ambulance (104 organizations share this tax ID)
Part of
Christiana Care Ambulance

Locations

1901 S College Ave
Newark, DE 19702
Phone (302) 369-1501

4701 Ogletown Stanton Rd
Ste 2200
Newark, DE 19713
Phone (302) 366-1200

190 Salem Church Rd
Newark, DE 19713
Phone (302) 454-5421

501 W 14th St
#4
Wilmington, DE 19801
Phone (302) 661-3070

390 Vineyard Way
Ste 501
West Grove, PA 19390
Phone (610) 869-0953

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian
Group: 193200000X MULTI-SPECIALTY GROUP		 133V00000X
Endocrinology, Diabetes & Metabolism Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RE0101X Yes
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363L00000X

Addresses

Primary practice location

3506 Kennett Pike
Pmri
Wilmington, DE 19807-3019

Mailing address

PO Box 30170
Wilmington, DE 19805-7170
Phone (302) 623-7019

Other identifiers

IdentifierTypeStateIssuer
1770568107MedicaidDE

Other names

  • CCHS PMRI Doing business as

Other providers in Wilmington, DE

All providers in Wilmington, DE · Endocrinology, Diabetes & Metabolism Physician in Delaware

Sources for this page

Verify at the official NPI Registry.