Individual provider Active NPI

Debra Sue Kelvin, L. AC., DIPL. AC.

  • Acupuncturist
  • Berkeley, CA
National Provider Identifier
1023137783
Registry record updated Aug 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC 8925 Issued in CA
Practice address
743 Addison St
Berkeley, CA 94710-1945
Phone
(510) 334-2472
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC 8925 CA Primary

Addresses

Primary practice location

743 Addison St
Berkeley, CA 94710-1945

Mailing address

743 Addison Street
Berkeley, CA 94710
Phone (510) 334-2472

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
AC 8925CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313971200000",
    "number": "1023137783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 ADDISON STREET",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94710",
            "telephone_number": "510-334-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 ADDISON ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947101945",
            "telephone_number": "510-334-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELVIN",
        "first_name": "DEBRA SUE",
        "credential": "L. AC., DIPL. AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2011-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC 8925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.