Individual provider Active NPI

Kirsten Faith Willoughby, PA-C

  • Physician Assistant
  • Newark, DE
National Provider Identifier
1952299430
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C5-0012301 Issued in DE
Practice address
4755 Ogletown Stanton Rd Ste 1070
Newark, DE 19718-2200
Phone
(302) 733-1212
Fax
(302) 733-4998
NPI assigned
Jun 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C5-0012301 DE Primary

Addresses

Primary practice location

4755 Ogletown Stanton Rd Ste 1070
Newark, DE 19718-2200

Mailing address

4755 Ogletown Stanton Rd Ste 1070
Newark, DE 19718-2200
Phone (302) 733-1212

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250717002573 DE Practitioner - Physician Assistant 7618483603 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services Inc CurrentSince Jul 3, 2025 Accepting new patients
Christiana Care Health Services, Inc CurrentSince Jul 3, 2025 Accepting new patients

Locations

4755 Ogletown Stanton Rd
Ste 1070
Newark, DE 19718
Phone (302) 733-1663

3521 Silverside Rd
Ste 1C
Wilmington, DE 19810
Phone (302) 368-3007

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/5c7467fb-60f9-4172-add4-57667a5dfcfa/

Organizations & group practices 3

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": "1750809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1952299430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD STE 1070",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-733-1212",
            "fax_number": "302-733-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD STE 1070",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-733-1212",
            "fax_number": "302-733-4998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLOUGHBY",
        "first_name": "KIRSTEN",
        "middle_name": "FAITH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-25",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0012301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.