Active NPI
Kimberly Meehan
- Psychiatry Physician
- New York, NY
National Provider Identifier
1023486610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 402330
- Practice address
- 18 E 41St St
FL 14 C/O Lina
New York, NY 10017-6244 - Phone
- (646) 434-8958
- Fax
- (979) 987-3062
- NPI assigned
- Sep 13, 2015
- Last updated
- Oct 13, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 402330 | NY | Primary |
Addresses
Primary practice location
18 E 41St St
FL 14 C/O Lina
New York, NY 10017-6244
Mailing address
18 E 41St St
FL 14 C/O Lina
New York, NY 10017-6244
Phone (401) 864-7253
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 402330 | NY | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Providence Center | Psychiatry | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602547200000",
"number": "1023486610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 E 41ST ST",
"address_2": "FL 14 C/O LINA",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100176244",
"telephone_number": "401-864-7253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 E 41ST ST",
"address_2": "FL 14 C/O LINA",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100176244",
"telephone_number": "646-434-8958",
"fax_number": "979-987-3062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEEHAN",
"first_name": "KIMBERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-13",
"last_updated": "2020-10-13",
"certification_date": "2020-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "402330",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.