Active NPI
Near Me Dermatology Dunkirk PLLC
- Family Nurse Practitioner
- Dunkirk, NY
National Provider Identifier
1548937014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Youn Jea Kim, FNP
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04401649 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | nmdermatology.hr@gmail.com | Direct |
National Provider Directory
National Provider DirectoryPractitioners & 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.
-
- Family Nurse Practitioner
- Buffalo, NY
- NPI 1376908442
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.