NPI Code Detail JSON Logo

1659462166 NPI number — NIKOLE FUNK DO

NPI Number: 1659462166
Health Care Provider/Practitioner: NIKOLE FUNK DO

Information about “1659462166” NPI (NIKOLE FUNK DO) exists in 1659462166 in HTML format HTML  |  1659462166 in plain Text format TXT  |  1659462166 in PDF (Portable Document Format) PDF  |  1659462166 in an XML format XML  formats.

NPI Number : 1659462166 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1659462166",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FUNK",
    "FirstName": "NIKOLE",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "DO",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 40412",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BELFAST",
    "MailingAddressStateName": "ME",
    "MailingAddressPostalCode": "04915-1255",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "248-824-6500",
    "MailingAddressFaxNumber": "855-618-6655",
    "FirstLinePracticeLocationAddress": "2452 SIR BARTON WAY STE 303",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LEXINGTON",
    "PracticeLocationAddressStateName": "KY",
    "PracticeLocationAddressPostalCode": "40509-2826",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "859-340-3233",
    "PracticeLocationAddressFaxNumber": "855-998-8574",
    "EnumerationDate": "09/28/2006",
    "LastUpdateDate": "10/24/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207P00000X",
          "TaxonomyName": "Emergency Medicine Physician",
          "LicenseNumber": "34008699",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208D00000X",
          "TaxonomyName": "General Practice Physician",
          "LicenseNumber": "34008699",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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