Individual provider Active NPI

Kimberly Estelle Farrow

  • Specialist
  • Fresh Meadows, NY
National Provider Identifier
1538895784
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
3745541 Issued in NY
Practice address
6143 186TH St
Fresh Meadows, NY 11365-2710
Phone
(900) 200-7105
Fax
(516) 324-8785
NPI assigned
Jul 29, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 3745541 NY Primary

Addresses

Primary practice location

6143 186TH St
Fresh Meadows, NY 11365-2710

Mailing address

245A Lexington Ave
Brooklyn, NY 11216-1115
Phone (646) 234-5999

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

State licenses

LicenseStateTypeSpecialty
3745541NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1538895784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245A LEXINGTON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112161115",
            "telephone_number": "646-234-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6143 186TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113652710",
            "telephone_number": "900-200-7105",
            "fax_number": "516-324-8785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARROW",
        "first_name": "KIMBERLY",
        "middle_name": "ESTELLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "3745541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.