Healthcare Provider Details

I. General information

NPI: 1700458874
Provider Name (Legal Business Name): REGIONAL ORTHOPAEDIC ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1082 OLD CHURCHMANS RD STE 100
NEWARK DE
19713-2143
US

IV. Provider business mailing address

1941 LIMESTONE RD STE 101
WILMINGTON DE
19808-5413
US

V. Phone/Fax

Practice location:
  • Phone: 302-655-9494
  • Fax:
Mailing address:
  • Phone: 302-655-9494
  • Fax: 302-691-1478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER BOSTWICK
Title or Position: COO
Credential:
Phone: 302-655-9494