NPIMap

Organization Active NPI

GK Dermatology SHN, LLC

  • Dermatology Physician
  • South Weymouth, MA
National Provider Identifier
1891239083
Registry record updated Dec 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
159743 Issued in MA
Legal business name
GK DERMATOLOGY SHN, LLC
Practice address
541 Main Street
Suite 320
South Weymouth, MA 02190-1845
Phone
(781) 812-1078
NPI assigned
Dec 7, 2016
Last updated
Dec 7, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
GK DERMATOLOGY, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 7, 2016

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

Authorized official

Name
George Kroumpouzos, MDNPI 1336121581
Title
President
Phone
(781) 812-1078

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
Dermatology Physician 207N00000X 159743 MA Primary

Addresses

Primary practice location

541 Main Street
Suite 320
South Weymouth, MA 02190-1845

Mailing address

541 Main Street
Suite 320
South Weymouth, MA 02190-1845
Phone (781) 812-1078

National Provider Directory

National Provider Directory
Part of
GK Dermatology PC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1481068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481068800000",
    "number": "1891239083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 MAIN STREET",
            "address_2": "SUITE 320",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "021901845",
            "telephone_number": "781-812-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 MAIN STREET",
            "address_2": "SUITE 320",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "021901845",
            "telephone_number": "781-812-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GK DERMATOLOGY SHN, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GK DERMATOLOGY, PC",
        "enumeration_date": "2016-12-07",
        "last_updated": "2016-12-07",
        "status": "A",
        "authorized_official_last_name": "KROUMPOUZOS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-812-1078",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "159743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Weymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; 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.