Christiana Care Health Services Inc
Organization Active NPI Family Medicine Physician · Kennett Square, PA
NPI 1821634858 · NPPES record last updated Mar 14, 2022
Key facts
- NPI
- 1821634858
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- CHRISTIANA CARE HEALTH SERVICES INC
- Practice address
- 721 E Baltimore Pike
Kennett Square, PA 19348-2405 - Phone
- (610) 765-4200
- NPI assigned
- Nov 25, 2019
- 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
Parent organization (reported in NPPES) 1
Other NPIs on the same Medicare enrollment 21
Practitioners 6
-
Kalia C. Cole-Avery, CRNP
-
April Lenette Franklin, LCSW
-
Sara Khanipour Roshan, M.D.
-
Diana C Matteo, M.D.
-
Samata McClure, DO, MPH
-
Aashka Shah, PA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080730000317 | PA | Part B Supplier - Clinic/Group Practice | 9739097569 |
Receives reassigned benefits from 198 practitioners 21 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: West Grove, PA; Kennett Square, PA; Chadds Ford, PA |
National Provider Directory
- Part of
- Christiana Care Ambulance
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Internal Medicine Physician |
207R00000X | |||
| Nurse Practitioner |
363L00000X | |||
| Family Nurse Practitioner |
363LF0000X |
Addresses
Primary practice location
721 E Baltimore Pike
Kennett Square, PA 19348-2405
Mailing address
200 Hygeia Dr Ste 2300
Newark, DE 19713-2049
Other practice location 1
390 Vineyard Way Ste 501
West Grove, PA 19390-8836
Phone (610) 869-0953
Other practice location 2
900 W Baltimore Pike Ste 200
West Grove, PA 19390-9313
Phone (610) 869-4627
Other providers in Kennett Square, PA
- Children'S Hospital of Philadelphia
- Children'S Hospital of Philadelphia
- Jordan M Chilla
- Christiana Care Health Services Inc
- Christiana Care Health Services Inc
- Leslie Church
- Marilyn Nicolette Ciavarra
- Kimberly Ann Cichanowsky
- Carol Lynn Ciliberti
- Samantha Cimabue
All providers in Kennett Square, PA · Family Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.