Active NPI
Kimberly Swan
- Registered Nurse
- Melville, NY
National Provider Identifier
1013648237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 733572
- Practice address
- 265 Broadhollow Rd
Melville, NY 11747-4833 - Phone
- (631) 278-4428
- NPI assigned
- Jun 20, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 733572 | NY | Primary |
Addresses
Primary practice location
265 Broadhollow Rd
Melville, NY 11747-4833
Mailing address
7 Elm St
East Patchogue, NY 11772-5756
Phone (631) 278-4428
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 733572-01 | Other | NY | NYS RN LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 733572 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753833600000",
"number": "1013648237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 ELM ST",
"city": "EAST PATCHOGUE",
"state": "NY",
"postal_code": "117725756",
"telephone_number": "631-278-4428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "265 BROADHOLLOW RD",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117474833",
"telephone_number": "631-278-4428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWAN",
"first_name": "KIMBERLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-20",
"last_updated": "2025-07-30",
"certification_date": "2025-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "733572",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NYS RN LICENSE",
"identifier": "733572-01",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Melville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.