NPIMap

Organization Active NPI

Christiana Spine Center PA

  • Physical Medicine & Rehabilitation Physician
  • Newark, DE
National Provider Identifier
1821059387
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
CHRISTIANA SPINE CENTER PA
Practice address
4735 Ogletown Stanton Rd Ste 3302
Newark, DE 19713
Phone
(302) 623-4144
Fax
(302) 623-4147
NPI assigned
Mar 31, 2006
Last updated
Sep 25, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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

Authorized official

Name
Valerie Manges
Title
Practice Administrator
Phone
(302) 996-9522

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X NU Primary

Addresses

Primary practice location

4735 Ogletown Stanton Rd Ste 3302
Newark, DE 19713

Mailing address

4735 Ogletown Stanton Rd
Suite 3302
Newark, DE 19713
Phone (302) 623-4144

Other practice location 1

1101 Twin C Ln Ste 202
Newark, DE 19713-2159
Phone (302) 623-4144

Other practice location 2

1101 Twin C Ln Ste 101
Newark, DE 19713-2158
Phone (302) 993-0280

Other practice location 3

4735 Ogletown Stanton Rd
Ste 3302
Newark, DE 19713
Phone (302) 623-4144

Other identifiers 5

IdentifierTypeStateIssuer
25305OtherDEUNITED HC
93388OtherDEAETNA
0000135302MedicaidDE
0078028000OtherDEAMERIHEALTH
CL3148OtherRAILROAD MCR

Other names 1

  • Physiatrists Associates Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051024000471 DE Part B Supplier - Clinic/Group Practice 6305862848 Receives reassigned benefits from 23 practitioners
Practice locations: Newark, DE
O20180202001770 DE DME Supplier - Physician - General Practice 6305862848 Practice locations: Newark, DE

National Provider Directory

National Provider Directory
Tax ID family
Christiana Spine Center PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1101 Twin C Ln
Ste 101
Newark, DE 19713
Phone (302) 633-1280

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537833600000",
    "number": "1821059387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4735 OGLETOWN STANTON RD",
            "address_2": "SUITE 3302",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19713",
            "telephone_number": "302-623-4144",
            "fax_number": "302-623-4147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 OGLETOWN STANTON RD STE 3302",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19713",
            "telephone_number": "302-623-4144",
            "fax_number": "302-623-4147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Twin C Ln Ste 202",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197132159",
            "country_code": "US",
            "telephone_number": "302-623-4144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 Twin C Ln Ste 101",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197132158",
            "country_code": "US",
            "telephone_number": "302-993-0280",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4735 Ogletown Stanton Rd",
            "address_2": "Ste 3302",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "19713",
            "country_code": "US",
            "telephone_number": "302-623-4144",
            "fax_number": "302-623-4147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHRISTIANA SPINE CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-31",
        "last_updated": "2018-09-25",
        "status": "A",
        "authorized_official_last_name": "MANGES",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "302-996-9522"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HC",
            "identifier": "25305",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "93388",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000135302",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0078028000",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR",
            "identifier": "CL3148",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physiatrists Associates",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Physiatrists Associates",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; 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.