Active NPI
Christine M Lundmark
- Speech-Language Pathologist
- Wilmington, DE
National Provider Identifier
1841461605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- O1-0000707
- Practice address
- 1004 Maple Ave
Wilmington, DE 19809-3015 - Phone
- (302) 562-3120
- Fax
- (302) 454-5443
- NPI assigned
- Mar 19, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | O1-0000707 | DE | Primary |
Addresses
Primary practice location
1004 Maple Ave
Wilmington, DE 19809-3015
Mailing address
1004 Maple Ave
Wilmington, DE 19809-3015
Phone (302) 562-3120
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0001087167 | Medicaid | DE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| O1-0000707 | DE | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205884800000",
"number": "1841461605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1004 MAPLE AVE",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198093015",
"telephone_number": "302-562-3120",
"fax_number": "302-454-5443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1004 MAPLE AVE",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198093015",
"telephone_number": "302-562-3120",
"fax_number": "302-454-5443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDMARK",
"first_name": "CHRISTINE",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-19",
"last_updated": "2008-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "DE",
"license": "O1-0000707",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0001087167",
"state": "DE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.