Individual provider Active NPI

Yvette Nicholson Gbemudu, M.D., M.A.

  • Family Medicine Physician
  • Wilmington, DE
National Provider Identifier
1912006552
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C10005485 Issued in DE
Practice address
601 New Castle Ave
Wilmington, DE 19801-5821
Phone
(302) 655-6187
Fax
(302) 655-6606
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C10005485 DE Primary

Addresses

Primary practice location

601 New Castle Ave
Wilmington, DE 19801-5821

Mailing address

601 New Castle Ave
Wilmington, DE 19801-5821
Phone (302) 655-6187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101230000202 DE Practitioner - Family Practice 5799973012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Jefferson Medical College of Thomas Jefferson University, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southbridge Medical Advisory Council IncGroup PAC ID 8426967928, 9 clinicians

Practice addresses (Care Compare)

601 New Castle Ave
Wilmington, DE 19801-5821
Phone (302) 655-6187

Hospital & facility affiliations

  • Christianacare Homehealth Home health agency, Wilmington, DE, CCN 087002
  • Compassionate Care Hospice Hospice, Newport, DE, CCN 081504
  • Christiana Hospital Hospital, Newark, DE, CCN 080001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Southbridge Medical Advisory Council Inc Family Medicine Current Accepting new patients

Locations

2722 Philadelphia Pike
Claymont, DE 19703
Phone (302) 655-6187

601 New Castle Ave
Wilmington, DE 19801
Phone (302) 655-6187

Interoperability endpoints

  • Direct secure messaging: yvettegbemudu@dhni.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Henrietta Johnson Medical CenterWilmington, DE, CCN 081801 Federally qualified health center Corporate Director
W-2 Managing Employee
Jan 5, 2015
Jan 5, 2015
Henrietta Johnson Med Center @ClaymontClaymont, DE, CCN 081816 Federally qualified health center Corporate Director
W-2 Managing Employee
Jan 5, 2015
Jan 5, 2015

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487894400000",
    "number": "1912006552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 NEW CASTLE AVE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198015821",
            "telephone_number": "302-655-6187",
            "fax_number": "302-655-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 NEW CASTLE AVE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198015821",
            "telephone_number": "302-655-6187",
            "fax_number": "302-655-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GBEMUDU",
        "first_name": "YVETTE",
        "middle_name": "NICHOLSON",
        "name_prefix": "Dr.",
        "credential": "M.D., M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2017-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C10005485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.