Active NPI
Medexpress, Inc. - Delaware
- Family Medicine Physician
- Newark, DE
National Provider Identifier
1992060016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- MEDEXPRESS, INC. - DELAWARE
- Practice address
- 1C Chestnut Hill Plaza
Newark, DE 19713 - Phone
- (302) 266-0930
- Fax
- (302) 266-0876
- NPI assigned
- Jul 5, 2012
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Joy Kimball
- Title
- Contract Manager
- Phone
- (763) 349-6740
Other NPIs on the same Medicare enrollment 4
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Medical Physician Assistant
- Wilmington, DE
- NPI 1356995245
-
- Physician Assistant
- Newark, DE
- NPI 1427561174
-
- Medical Physician Assistant
- Limerick, PA
- NPI 1750710513
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DE
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120808000579 | DE | Part B Supplier - Clinic/Group Practice | 5294981163 |
Receives reassigned benefits from 34 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Newark, DE; Wilmington, DE; New Castle, DE; Dover, DE |
National Provider Directory
National Provider DirectorySpecialties & licenses 2
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary | ||
| Emergency Care Clinic/Center | 261QE0002X |
Addresses
NPPES NPI RegistryPrimary practice location
1C Chestnut Hill Plaza
Newark, DE 19713
Mailing address
423 Fortress Blvd
Morgantown, WV 26508-1351
Phone (304) 225-2500
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255692182 | Medicaid | DE |
Other names 1
NPPES NPI Registry- MedExpress - Newark
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 7, 2024.
{
"created_epoch": "1341446400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1715040000000",
"number": "1992060016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "423 FORTRESS BLVD",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265081351",
"telephone_number": "304-225-2500",
"fax_number": "304-985-6350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1C CHESTNUT HILL PLAZA",
"city": "NEWARK",
"state": "DE",
"postal_code": "19713",
"telephone_number": "302-266-0930",
"fax_number": "302-266-0876"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDEXPRESS, INC. - DELAWARE",
"organizational_subpart": "NO",
"enumeration_date": "2012-07-05",
"last_updated": "2024-05-07",
"certification_date": "2024-05-07",
"status": "A",
"authorized_official_last_name": "KIMBALL",
"authorized_official_first_name": "JOY",
"authorized_official_title_or_position": "CONTRACT MANAGER",
"authorized_official_telephone_number": "763-349-6740"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QE0002X",
"taxonomy_group": "",
"desc": "Clinic/Center, Emergency Care",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1255692182",
"state": "DE"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "MedExpress - Newark",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Newark, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.