Michael John Dorn, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

358795 Issued in NY

Practice address

13 Green Knoll CT
Northport, NY 11768-1357

Phone

(631) 278-5864

NPI assigned

Feb 4, 2014

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1391472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391472000000",
    "number": "1194149666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 GREEN KNOLL CT",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117681357",
            "telephone_number": "631-278-5864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 GREEN KNOLL CT",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117681357",
            "telephone_number": "631-278-5864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORN",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-04",
        "last_updated": "2014-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "358795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candice Distefano, OD
• Jason Distefano, DPT
• Troy Everett Dixon, M.D.
• Barbara M Donahue, NP
• Sharon Etta Donenfeld, MA, LMFT
• Reisa P Doyle, NP
• Dr Christopher Bux PT PLLC
• Dr Richard E Young and Dr Arlene L Vazquez Young PC
• Dr. Colleen Erin McKechnie, Psychologist
• Bernadette Dube

• All providers in Northport, NY
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; 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.