Brandywine OBGYN, PA

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

C20005691 Issued in DE

Legal business name

BRANDYWINE OBGYN, PA

Practice address

3519 Silverside Rd
Suite 204 Ridgely BLDG
Wilmington, DE 19810-4909

Phone

(302) 477-1375

Fax

(302) 477-1383

NPI assigned

Nov 8, 2007

Last updated

Dec 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael B Cooksey, DONPI 1487692653

Title

President

Phone

(302) 477-1375

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael B Cooksey, DO

  • Obstetrics & Gynecology Physician
  • Wilmington, DE
  • NPI 1487692653
  Authorized official Same address or phone
• Walter Kobasa Jr., MD

  • Obstetrics & Gynecology Physician
  • Milford, DE
  • NPI 1891876009
  NPD (past)

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228694400000",
    "number": "1962682849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3519 SILVERSIDE RD",
            "address_2": "SUITE 204 RIDGELY BLDG",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104909",
            "telephone_number": "302-477-1375",
            "fax_number": "302-477-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3519 SILVERSIDE RD",
            "address_2": "SUITE 204 RIDGELY BLDG",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104909",
            "telephone_number": "302-477-1375",
            "fax_number": "302-477-1383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDYWINE OBGYN, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2008-12-08",
        "status": "A",
        "authorized_official_last_name": "COOKSEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "302-477-1375",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "DE",
            "license": "C20005691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000013840",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Brandywine Optical Inc
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• Brandywine Pediatric Dentistry, P.a.
• Brandywine Pediatrics, P.a.

• Obstetrics & Gynecology Physician in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Obstetrics & Gynecology Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.

Verify at the official NPI Registry.