King-Maceyko Dermatology Assoc LTD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

KING-MACEYKO DERMATOLOGY ASSOC LTD

Practice address

223 S Pleasant Ave
Suite 101
Somerset, PA 15501

Phone

(814) 443-6918

Fax

(814) 539-3927

NPI assigned

Jun 20, 2008

Organization subpart

Yes

Parent organization

KING-MACEYKO DERMATOLOGY ASSOC LTDAs reported in NPPES

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

Authorized official

Name

Sandra H King

Title

Practice Administrator

Phone

(814) 536-7045

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Fred G Hamathy

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1669633814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 SOUTHMONT BLVD",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054330",
            "telephone_number": "814-536-7045",
            "fax_number": "814-539-3927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 S PLEASANT AVE",
            "address_2": "SUITE 101",
            "city": "SOMERSET",
            "state": "PA",
            "postal_code": "15501",
            "telephone_number": "814-443-6918",
            "fax_number": "814-539-3927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING-MACEYKO DERMATOLOGY ASSOC LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KING-MACEYKO DERMATOLOGY ASSOC LTD",
        "enumeration_date": "2008-06-20",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "814-536-7045"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD MEDICARE GROUP NUMBER",
            "identifier": "721126",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristina L Kennell, MOT, OTR/L
• Jill Kennington-Slope
• Michelle Ann Kibler
• Sandra Friedline Kimmel, RPH
• Tonya Kimmel
• Amber Lynn King, LPC, M.S.
• Kathryn Elizabeth King, DPT
• Maggie Mae Kist, DPT
• Kyle Kister
• Kristen Kizer

• Dermatology Physician in Somerset, PA
• Providers in Somerset, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.