436TH MEDGRP-DOVER
NPI 1437112646
Clinic/Center - Military/U.S. Coast Guard Outpatient in Dover Afb, DE
NPI Status: Active since April 10, 2006
Contact Information
300 TUSKEGEE BLVD
DOVER AFB, DE
ZIP 19902
Phone: (302) 677-2649
Fax: (302) 677-2051
- Organization
- Clinic/Center
- Military/U.S. Coast Guard Outpatient
About 436TH MEDGRP-DOVER
This page provides the complete NPI Profile along with additional information for 436th Medgrp-dover, a provider established in Dover Afb, Delaware operating as a Clinic/center, focusing in military/u.s. coast guard outpatient . The healthcare provider is registered in the NPI registry with number 1437112646 assigned on April 2006. The practitioner's primary taxonomy code is 261QM1100X. The provider is registered as an organization and their NPI record was last updated June 2025. The provider's
- NPI
- 1437112646
- Provider Legal Name
- 436TH MEDGRP-DOVER
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 300 TUSKEGEE BLVD DOVER AFB, DE 19902
- Location Phone
- (302) 677-2649
- Location Fax
- (302) 677-2051
- Mailing Address
- 300 TUSKEGEE BLVD DOVER AFB, DE 19902
- Mailing Phone
- (302) 677-2649
- Mailing Fax
- (302) 677-2051
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 04-10-2006
- Last Update Date
- 06-16-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Military/U.S. Coast Guard Outpatient
- Taxonomy Code
- 261QM1100X
- Type
- Ambulatory Health Care Facilities
- License State
- DE
- Taxonomy Description
- The Defense Health Program or U.S. Coast Guard funded fixed facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A fixed facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the fixed facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QM1101X | Ambulatory Health Care Facilities | Clinic/Center | (DE) |
| 2 | 332000000X | Suppliers | Military/U.S. Coast Guard Pharmacy |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 08-03735 | OTHER (01) | DE | NCPDP |
Reviews for 436TH MEDGRP-DOVER
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 3 | 7 | 1 | 1 | 2 | 6 | 4 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 6 | 7 | 2 | 1 | 4 | 6 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 6 + 7 + 2 + 1 + 4 + 6 + 8 + 24 = 64 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 64 = 6 | 6 | ||||||||
The NPI number 1437112646 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1376536813 | DR. PHILLIP WARREN PETTERBORG OD Individual | Optometrist | 300 TUSKEGEE BLVD DOVER AFB, DE 19902 (302) 677-2574 |
| 1558355420 | DR. CORA INETTIE RANDLE MD Individual | Internal Medicine | 300 TUSKEGEE BLVD DOVER AFB, DE 19902 (302) 677-2525 |
| 1588651020 | TIMOTHY LEE PENDERGRASS MD Individual | Radiology (Diagnostic Radiology) | 300 TUSKEGEE BLVD 436 MDG CC STE 1B22 DOVER AFB, DE 19902 (302) 677-2525 |
| 1598755084 | DR. GEOFFREY WALLACE CRAWLEY M.D. Individual | Radiology (Diagnostic Radiology) | 300 TUSKEGEE BLVD DOVER AFB, DE 19902 (302) 677-2608 |
| 1295712800 | DR. VINCENT PAUL FLORYSHAK DDS Individual | Dentist | 300 TUSKEGEE BLVD DOVER AFB, DE 19902 (302) 677-2549 |
| 1376520981 | DR. CHRISTOPHER FRANCIS FLYNN MD Individual | Psychiatry & Neurology (Psychiatry) | 300 TUSKEGEE BLVD DOVER AFB, DE 19902 (302) 677-2498 |
| 1578540225 | DR. AREZOO BARANI DDS Individual | Dentist | 300 TUSKEGEE BLVD DOVER AFB, DE 19902 (302) 677-2227 |
| 1154308831 | ROBIN EDMUND JACKSON MSW Individual | Counselor (Mental Health) | 300 TUSKEGEE BLVD DOVER AFB, DE 19902 (302) 677-3911 |
| 1669459343 | DENISE INGA COLEMAN MSW Individual | Counselor (Mental Health) | 300 TUSKEGEE BLVD DOVER AFB, DE 19902 (302) 677-2711 |
| 1609853308 | MARCIA ALYSE POTTER NP Individual | Nurse Practitioner (Primary Care) | 300 TUSKEGEE BLVD DOVER AFB, DE 19902 (302) 677-2669 |
| 1326025024 | DR. SUSAN MONTEMAYOR PEREZ DE TAGLE MD Individual | Family Medicine | 300 TUSKEGEE BLVD DOVER, DE 19902 (302) 677-2525 |
| 1861479453 | DR. MATTHEW JOHN CAZAN JR. MD Individual | Family Medicine | 300 TUSKEGEE BLVD DOVER AFB, DE 19902 (302) 677-2549 |
| 1992782379 | ALICIA ANNE MATTESON MA Individual | Psychologist | 300 TUSKEGEE BLVD DOVER AFB, DE 19902 (302) 677-2674 |
| 1952389744 | DR. AARON MATTHEW SWENSON DDS Individual | Dentist | 300 TUSKEGEE BLVD DOVER AFB, DE 19902 (302) 677-2201 |
| 1770561524 | DR. ERICA DENISE RADDEN MD Individual | Family Medicine | 300 TUSKEGEE BLVD 436 MDG DOVER, DE 19902 (302) 677-2600 |
| 1679552343 | MR. WINSTON RYDER WITHERELL PT Individual | Physical Therapist | 300 TUSKEGEE BLVD 436 MEDICAL GROUP DOVER AFB, DE 19902 (302) 677-2568 |
| 1952448037 | LYNITTA DENISE MCCOY PA Individual | Physician Assistant | 300 TUSKEGEE BLVD DOVER AFB, DE 19902 (302) 677-2585 |
| 1225164080 | MRS. CATHERINE MARY JENNINGS RD Individual | Dietitian, Registered | 300 TUSKEGEE BLVD 436 ADOS SGGZ DOVER AFB, DE 19902 (302) 677-3733 |
| 1053449801 | MARCELLA MARIE FLEMING RPH Individual | Pharmacist | 300 TUSKEGEE BLVD DOVER AFB, DE 19902 (302) 677-2547 |
| 1245496991 | BERNADETTE ANN FACKOVEC MSW Individual | Social Worker | 300 TUSKEGEE BLVD MENTAL HEALTH FLIGHT DOVER AFB, DE 19902 (302) 677-2711 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1437112646, enumerated in the NPI registry as an "organization" on April 10, 2006
The provider is located at 300 Tuskegee Blvd Dover Afb, De 19902 and the phone number is (302) 677-2649
This medical organization specializes in Clinic/Center with taxonomy code 261QM1100X with a focus in Military/U.S. Coast Guard Outpatient
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on April 10, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.