Kim Dovalo

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ00484100 Issued in NJ

Practice address

90 Bergen St Ste 8100
Newark, NJ 07103-2425

Phone

(973) 972-2897

NPI assigned

Jul 8, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Children of Joy Pediatrics

  • Pediatrics Physician
  • Hackensack, NJ
  • NPI 1144464553
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459987200000",
    "number": "1043626211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 BERGEN ST STE 8100",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-2897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BERGEN ST STE 8100",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-2897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOVALO",
        "first_name": "KIM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-08",
        "last_updated": "2016-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00484100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Leigh Doshan
• Dhvani Doshi, M.D., M.P.H.
• Jayan Doshi, RPH
• Jason Maurice Dotson, LPC, LCADC
• Nataki Celeste Douglas, M.D.
• Christina Elise Dowe, MD MPH
• Marcia Claudette Downer, PT
• Douglas T Downey, D.M.D.
• Melissa Marie Doyle, PHD, LCSW
• Dr Eduardo Samaniego - Primary Medical Care LLC

• Family Nurse Practitioner in Newark, NJ
• Providers in Newark, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.