Supple Mind Acupuncture P.C.

Primary specialty

AcupuncturistTaxonomy code 171100000X

Legal business name

SUPPLE MIND ACUPUNCTURE P.C.

Practice address

4160 Main St Ste 209a
Flushing, NY 11355-3899

Phone

(917) 933-8503

Fax

(917) 463-1056

NPI assigned

Feb 4, 2019

Organization subpart

No

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

Authorized official

Name

Mun S Shieh, L.AC

Title

President

Phone

(917) 362-2018

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew Lee

  • Acupuncturist
  • New York, NY
  • NPI 1023614732
  NPD (past)

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

{
    "created_epoch": "1549238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596758400000",
    "number": "1003371022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6914 183RD ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113653536",
            "telephone_number": "917-362-2018",
            "fax_number": "917-463-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 MAIN ST STE 209A",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553899",
            "telephone_number": "917-933-8503",
            "fax_number": "917-463-1056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3808 Union St Ste 8C",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113545673",
            "country_code": "US",
            "telephone_number": "917-362-2018",
            "fax_number": "917-463-1056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUPPLE MIND ACUPUNCTURE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-04",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A",
        "authorized_official_last_name": "SHIEH",
        "authorized_official_first_name": "MUN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-362-2018",
        "authorized_official_credential": "L.AC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; 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.