Individual provider Active NPI

Debbie Lynn Korwin, MD

  • Pediatrics Physician
  • Grand Island, NY
National Provider Identifier
1124342142
Registry record updated Mar 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
161885-1 Issued in NY
Practice address
167 White Tail Run
Grand Island, NY 14072-3223
Phone
(716) 773-1632
NPI assigned
Mar 19, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 161885-1 NY Primary

Addresses

Primary practice location

167 White Tail Run
Grand Island, NY 14072-3223

Mailing address

167 White Tail Run
Grand Island, NY 14072-3223
Phone (716) 773-1632

Other identifiers 1

IdentifierTypeStateIssuer
161885-1OtherNYMEDICAL 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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
161885-1NYMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268956800000",
    "number": "1124342142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 WHITE TAIL RUN",
            "city": "GRAND ISLAND",
            "state": "NY",
            "postal_code": "140723223",
            "telephone_number": "716-773-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 WHITE TAIL RUN",
            "city": "GRAND ISLAND",
            "state": "NY",
            "postal_code": "140723223",
            "telephone_number": "716-773-1632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORWIN",
        "first_name": "DEBBIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-19",
        "last_updated": "2010-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "161885-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "161885-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2010; 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.