Active NPI
Functional Nurse Practitioner in Family Health
- Family Nurse Practitioner
- New York, NY
National Provider Identifier
1619862943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- FUNCTIONAL NURSE PRACTITIONER IN FAMILY HEALTH
- Practice address
- 2 W 32ND St Ste 602
New York, NY 10001-0602 - Phone
- (917) 309-0729
- NPI assigned
- Jun 9, 2025
- 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
- Hyunchu Kim Gold, NP
- Title
- Staff Nurse Practitioner
- Phone
- (917) 309-0729
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
2 W 32ND St Ste 602
New York, NY 10001-0602
Mailing address
2 W 32ND St Ste 602
New York, NY 10001-0602
Phone (917) 309-0729
Other names 1
- Revive wellness
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.
-
- Family Nurse Practitioner
- New York, NY
- NPI 1033508551
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1749427200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1750809600000",
"number": "1619862943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 W 32ND ST STE 602",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100010602",
"telephone_number": "917-309-0729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 W 32ND ST STE 602",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100010602",
"telephone_number": "917-309-0729"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FUNCTIONAL NURSE PRACTITIONER IN FAMILY HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2025-06-09",
"last_updated": "2025-06-25",
"certification_date": "2025-06-25",
"status": "A",
"authorized_official_last_name": "KIM GOLD",
"authorized_official_first_name": "HYUNCHU",
"authorized_official_title_or_position": "STAFF NURSE PRACTITIONER",
"authorized_official_telephone_number": "917-309-0729",
"authorized_official_credential": "NP"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Revive wellness",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "Revive wellness",
"code": "5",
"type": "Other Name"
}
]
}Other providers in New York, NY
- Functional Life Achievement, Inc
- Functional Life Achievement, Inc.
- Functional Life Achievement. Ink.
- Functional Life Achievements Inc
- Functional Manual Physical Therapy Services
- Functional Pelvis Inc
- Harjienne Deive Fundal
- Fundamental Acupuncture PLLC
- Casey Norei Funderburk
- Christopher D. Funderburk, M.D., M.S.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.