Individual provider Active NPI

Khadija Adam Zakaria, FNP

  • Primary Care Nurse Practitioner
  • Wilmington, DE
National Provider Identifier
1780908392
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
LG-0012580 Issued in DE
Practice address
1601 Kirkwood Hwy
Wilmington, DE 19805-4917
Phone
(302) 994-2511
NPI assigned
Mar 25, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X L1-0049662 NY
Primary Care Nurse Practitioner 363LP2300X LG-0012580 DE Primary

Addresses

Primary practice location

1601 Kirkwood Hwy
Wilmington, DE 19805-4917

Mailing address

505 Gordon House Way
Middletown, DE 19709-9974
Phone (347) 488-0692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250527000630 DE Practitioner - Nurse Practitioner 8729507488 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
L1-0049662NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Premiere Physicians P.a. CurrentSince May 1, 2025 Accepting new patients
Complete Sleep Lab Inc CurrentSince May 1, 2025 Accepting new patients

Locations

314 E Main St
Ste 103
Newark, DE 19711
Phone (302) 366-0550

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1780908392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 GORDON HOUSE WAY",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197099974",
            "telephone_number": "347-488-0692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 KIRKWOOD HWY",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198054917",
            "telephone_number": "302-994-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAKARIA",
        "first_name": "KHADIJA",
        "middle_name": "ADAM",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-25",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "L1-0049662",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "DE",
            "license": "LG-0012580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.