Individual provider Active NPI

Emily Ann Nyberg, LAC, DIPL. AC., MAC

  • Acupuncturist
  • Minneapolis, MN
National Provider Identifier
1003665472
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
2079 Issued in MN
Practice address
1224 2ND St NE
Minneapolis, MN 55413-1130
Phone
(612) 345-5648
NPI assigned
May 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 2079 MN Primary

Addresses

Primary practice location

1224 2ND St NE
Minneapolis, MN 55413-1130

Mailing address

3300 41St Ave S Apt 2
Minneapolis, MN 55406-2281
Phone (651) 895-9816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2079MNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Integrative Health Studio Acupuncturist CurrentSince May 19, 2024 Accepting new patients

Locations

1224 2nd St NE
Minneapolis, MN 55413
Phone (612) 345-5648

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1003665472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 41ST AVE S APT 2",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554062281",
            "telephone_number": "651-895-9816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 2ND ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131130",
            "telephone_number": "612-345-5648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYBERG",
        "first_name": "EMILY",
        "middle_name": "ANN",
        "credential": "LAC, DIPL. AC., MAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "2079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; 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.