| Medexpress - Wilmington Concord Pike | |
|
2722 Concord Pike Wilmington DE 19803-5007 | |
| (302) 477-1406 | |
| (302) 477-1495 |
| Full Name | Medexpress - Wilmington Concord Pike |
|---|---|
| Speciality | Family Medicine |
| Location | 2722 Concord Pike, Wilmington, Delaware |
| Authorized Official Name and Position | Joy Kimball (CONTRACT MANAGER) |
| Authorized Official Contact | 7633496740 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medexpress - Wilmington Concord Pike 423 Fortress Blvd Morgantown WV 26508-1351 Ph: (304) 225-2500 | Medexpress - Wilmington Concord Pike 2722 Concord Pike Wilmington DE 19803-5007 Ph: (302) 477-1406 |
| NPI Number | 1255692182 |
|---|---|
| Provider Enumeration Date | 06/07/2012 |
| Last Update Date | 05/07/2024 |
| Medicare PECOS PAC ID | 5294981163 |
|---|---|
| Medicare Enrollment ID | O20120808000579 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255692182 | NPI | - | NPPES |
| 1255692182 | Medicaid | DE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QE0002X | Clinic/center - Emergency Care | (* (Not Available)) | Secondary |
| Provider Name | Stephen Ogden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740316678 PECOS PAC ID: 2264515071 Enrollment ID: I20080215000496 |
| Provider Name | Hema M Gouru |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760506240 PECOS PAC ID: 8325193634 Enrollment ID: I20090909000499 |
| Provider Name | Lynnanne Kasarda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528126844 PECOS PAC ID: 2860533361 Enrollment ID: I20100106000335 |
| Provider Name | Lisa A Martin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427050665 PECOS PAC ID: 5799775466 Enrollment ID: I20101027000243 |
| Provider Name | Michael J Richards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881891083 PECOS PAC ID: 6002995065 Enrollment ID: I20101201001115 |
| Provider Name | Hillel Wirsztel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1760664767 PECOS PAC ID: 1254486921 Enrollment ID: I20101203001142 |
| Provider Name | Oluseyi N Senu-oke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235137613 PECOS PAC ID: 3971545203 Enrollment ID: I20110826000032 |
| Provider Name | David R Ferrell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376542290 PECOS PAC ID: 0345255311 Enrollment ID: I20120809000339 |
| Provider Name | Oliver Thresher |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063504264 PECOS PAC ID: 5092883215 Enrollment ID: I20121113000150 |
| Provider Name | Preet D Joshi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538391347 PECOS PAC ID: 0446494678 Enrollment ID: I20130910000259 |
| Provider Name | Jing Wei |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154426500 PECOS PAC ID: 3274539465 Enrollment ID: I20131223001595 |
| Provider Name | Linda K Eld |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821098369 PECOS PAC ID: 9032185533 Enrollment ID: I20140617001427 |
| Provider Name | Barbara Sewerin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881892065 PECOS PAC ID: 2264691674 Enrollment ID: I20150219000454 |
| Provider Name | Shannon L Childs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609231422 PECOS PAC ID: 0345544003 Enrollment ID: I20160314002406 |
| Provider Name | Valerie E Goodman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659334852 PECOS PAC ID: 5193918258 Enrollment ID: I20170928000170 |
| Provider Name | Alicia Camille Vogleson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952825168 PECOS PAC ID: 2860768603 Enrollment ID: I20171024001264 |
| Provider Name | Jeena Zachariah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285028233 PECOS PAC ID: 5092006163 Enrollment ID: I20180212002302 |
| Provider Name | Johnita C Tiller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083191076 PECOS PAC ID: 5597013292 Enrollment ID: I20180810002319 |
| Provider Name | Megan Marie Morsello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306301791 PECOS PAC ID: 0840527818 Enrollment ID: I20190814000435 |
| Provider Name | Sidonie Simone Salmon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679115067 PECOS PAC ID: 9739508672 Enrollment ID: I20200928000480 |
| Provider Name | Latanya Keyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821603945 PECOS PAC ID: 7618396037 Enrollment ID: I20201002001747 |
| Provider Name | Michael Vito Dimucci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083694806 PECOS PAC ID: 1759286842 Enrollment ID: I20210908004192 |
| Provider Name | Ravi V Sharma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023412368 PECOS PAC ID: 2264720564 Enrollment ID: I20220221000692 |
| Provider Name | Kelvinna Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912249343 PECOS PAC ID: 3870728165 Enrollment ID: I20220622001255 |
| Provider Name | Melanie Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952822280 PECOS PAC ID: 3274809512 Enrollment ID: I20220804000130 |
| Provider Name | Faredoon Misaghi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427097302 PECOS PAC ID: 9638063076 Enrollment ID: I20221108001731 |
| Provider Name | Nicole Tiefel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326438599 PECOS PAC ID: 8123392586 Enrollment ID: I20221110002351 |
| Provider Name | Sandra Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134408461 PECOS PAC ID: 6608047386 Enrollment ID: I20221210000107 |
| Provider Name | David Berkson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588756233 PECOS PAC ID: 6103822903 Enrollment ID: I20221229001001 |
| Provider Name | Akita Miller-abbey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871011544 PECOS PAC ID: 7911263207 Enrollment ID: I20230126000007 |
| Provider Name | Marek Didluch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750312641 PECOS PAC ID: 1951366756 Enrollment ID: I20230208003108 |
| Provider Name | Danita Fox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013236207 PECOS PAC ID: 9739406307 Enrollment ID: I20230421000973 |
| Provider Name | David Hefner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013114610 PECOS PAC ID: 7517016355 Enrollment ID: I20230707003710 |
| Provider Name | Paula Kay Fontenote |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770569931 PECOS PAC ID: 5890719934 Enrollment ID: I20240425000285 |
| Provider Name | Julie Lynn Waddell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700843125 PECOS PAC ID: 0840233565 Enrollment ID: I20240507002360 |
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