Shine Functional Dermatology

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

SHINE FUNCTIONAL DERMATOLOGY

Doing business as

Association of Phototherapy Professionals
Phototherapy Training Institute
Shine Phototherapy Center

Practice address

566 E St
Lincoln, CA 95648-1861

Phone

(916) 645-1447

Fax

(916) 645-1447

NPI assigned

Nov 23, 2021

Last updated

Oct 24, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kathrine M Varman, MD

Title

MD/Owner

Phone

(916) 953-3812

Specialties & licenses 3

Addresses

Other names 3

• Association of Phototherapy Professionals Doing business as
• Phototherapy Training Institute Doing business as
• Shine Phototherapy Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Katherine Marie Varman, MD

  • Dermatology Physician
  • Lincoln, CA
  • NPI 1780942607

  Multi-Specialty

  Medicare reassignment NPD
• Abbey Crews

  • Other Specialist/Technologist
  • Lincoln, CA
  • NPI 1952009060

  Specialist/Technologist, Other

  NPD
• Kailauna Mills

  • Other Specialist/Technologist
  • Lincoln, CA
  • NPI 1730962531

  Specialist/Technologist, Other

  NPD

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

{
    "created_epoch": "1637625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698105600000",
    "number": "1205593316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "566 E ST",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956481861",
            "telephone_number": "916-645-1447",
            "fax_number": "866-502-3465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "566 E ST",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956481861",
            "telephone_number": "916-645-1447",
            "fax_number": "916-645-1447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINE FUNCTIONAL DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-23",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A",
        "authorized_official_last_name": "VARMAN",
        "authorized_official_first_name": "KATHRINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "916-953-3812",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "202D00000X",
            "taxonomy_group": "",
            "desc": "Integrative Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Association of Phototherapy Professionals",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Phototherapy Training Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shine Phototherapy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Serene Wellness Pharmacy, Inc
• Garrett Marc Sessions, DPM
• Robyn Lee Sevigny, LMFT
• Erin Jacks Shaw, M.D.
• Misty Dawn Sheldon
• Brett C Shumate, DPT
• Olivia Silva
• Yvonne Sinclair, LMFT
• Johnson Siu
• Nina Skellenger, PPS

• Dermatology Physician in Lincoln, CA
• Providers in Lincoln, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.