Sports Medicine of Delaware, Inc.

Primary specialty

Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X

License

C2-0005338 Issued in DE

Legal business name

SPORTS MEDICINE OF DELAWARE, INC.

Practice address

102 Sleepy Hollow Dr
Suite 102
Middletown, DE 19709-8894

Phone

(302) 376-9711

Fax

(302) 376-9713

NPI assigned

Jun 1, 2006

Organization subpart

No

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

Authorized official

Name

Vincent Neil Disabella, DO

Title

President

Phone

(302) 376-9711

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225756800000",
    "number": "1790722478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 SLEEPY HOLLOW DR",
            "address_2": "SUITE 102",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197095841",
            "telephone_number": "302-376-9711",
            "fax_number": "302-376-9713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 SLEEPY HOLLOW DR",
            "address_2": "SUITE 102",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197098894",
            "telephone_number": "302-376-9711",
            "fax_number": "302-376-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE OF DELAWARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2008-11-04",
        "status": "A",
        "authorized_official_last_name": "DISABELLA",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "NEIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "302-376-9711",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "DE",
            "license": "C2-0005338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "2803109000",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100040718",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Cheyonne Solomon, MSS MLSP
• Irene M. Soucy, R.D.
• Soul-Full Presence LLC
• Southern Delaware Sportscare and Rehabilitation, LLC
• Jennifer Marie Spencer, PHARMD
• Sreeman LLC
• Staffmore
• State of Delaware
• State of Delaware Dscyf
• State of Delaware Dscyf

• Sports Medicine (Internal Medicine) Physician in Middletown, DE
• Providers in Middletown, DE by specialty
• Sports Medicine (Internal Medicine) Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; 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.