NPIMap

Organization Active NPI

Stephen Lynne McKee DDS, PLLC

  • General Practice Dentistry
  • Waverly, NY
National Provider Identifier
1841595022
Registry record updated Jan 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
54919 Issued in NY
Legal business name
STEPHEN LYNNE MCKEE DDS, PLLC
Practice address
284 State Route 17C
Waverly, NY 14892-9507
Phone
(607) 565-7811
Fax
(607) 565-7165
NPI assigned
Jan 19, 2011
Last updated
Jan 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2011

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

Authorized official

Name
Dr. Stephen Lynne McKee, DDSNPI 1265660435
Title
Owner
Phone
(607) 565-7811

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 54919 NY Primary

Addresses

Primary practice location

284 State Route 17C
Waverly, NY 14892-9507

Mailing address

284 State Route 17C
Waverly, NY 14892-9507
Phone (607) 565-7811

Other identifiers 2

IdentifierTypeStateIssuer
1025377340001MedicaidPA
03270284MedicaidNY

National Provider Directory

National Provider Directory

Locations

284 State Route 17C
Waverly, NY 14892
Phone (607) 565-7811

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": "1295395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295395200000",
    "number": "1841595022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 STATE ROUTE 17C",
            "city": "WAVERLY",
            "state": "NY",
            "postal_code": "148929507",
            "telephone_number": "607-565-7811",
            "fax_number": "607-565-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "284 STATE ROUTE 17C",
            "city": "WAVERLY",
            "state": "NY",
            "postal_code": "148929507",
            "telephone_number": "607-565-7811",
            "fax_number": "607-565-7165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN LYNNE MCKEE DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-19",
        "last_updated": "2011-01-19",
        "status": "A",
        "authorized_official_last_name": "MCKEE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "607-565-7811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "54919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1025377340001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03270284",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waverly, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; 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.