Individual provider Active NPI

Isaac Iverson Qwepue, NURSING

  • Intellectual & Developmental Disabilities Psychologist
  • Dover, DE
National Provider Identifier
1871020164
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
License
2468 Issued in DE
Practice address
229 Jordan Dr
Dover, DE 19904-2004
Phone
(215) 431-5197
Fax
(302) 674-5259
NPI assigned
May 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities Psychologist 103TM1800X 2468 DE Primary

Addresses

Primary practice location

229 Jordan Dr
Dover, DE 19904-2004

Mailing address

229 Jordan Dr
Dover, DE 19904-2004
Phone (215) 431-5197

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

LicenseStateTypeSpecialty
2468DEMDIntellectual & Developmental Disabilities Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
I & K Quality Health Care Intellectual & Developmental Disabilities CurrentSince Jul 24, 2022 Accepting new patients

Organizations & group practices 1

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": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1871020164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 JORDAN DR",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199042004",
            "telephone_number": "215-431-5197",
            "fax_number": "302-674-5259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 JORDAN DR",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199042004",
            "telephone_number": "215-431-5197",
            "fax_number": "302-674-5259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QWEPUE",
        "first_name": "ISAAC",
        "middle_name": "IVERSON",
        "credential": "NURSING",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "DE",
            "license": "2468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.