Organization Active NPI

Near Me Dermatology Dunkirk PLLC

  • Family Nurse Practitioner
  • Dunkirk, NY
National Provider Identifier
1548937014
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
NEAR ME DERMATOLOGY DUNKIRK PLLC
Practice address
609 Central Ave
Dunkirk, NY 14048-2538
Phone
(213) 880-2538
NPI assigned
Aug 24, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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

Authorized official

Name
Mrs. Youn Jea Kim, FNPNPI 1376908442
Title
Owner
Phone
(213) 880-2538

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

609 Central Ave
Dunkirk, NY 14048-2538

Mailing address

1170 Maple Rd
Williamsville, NY 14221-3440
Phone (213) 880-2538

Other identifiers 1

IdentifierTypeStateIssuer
04401649MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL nmdermatology.hr@gmail.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1548937014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 MAPLE RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213440",
            "telephone_number": "213-880-2538",
            "fax_number": "716-249-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 CENTRAL AVE",
            "city": "DUNKIRK",
            "state": "NY",
            "postal_code": "140482538",
            "telephone_number": "213-880-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEAR ME DERMATOLOGY DUNKIRK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "YOUN JEA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-880-2538",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04401649",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "nmdermatology.hr@gmail.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "609 Central Ave",
            "city": "Dunkirk",
            "state": "NY",
            "country_code": "US",
            "postal_code": "140482538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dunkirk, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.