An Medi-Zen, PLLC

Key facts

NPI

1104665041

Entity type

Organization (NPI type 2)

Primary specialty

Acupuncturist 171100000X

Legal business name

AN MEDI-ZEN, PLLC

Practice address

124 S. Broadway Street
Suite 1
Greenville, MS 38701

Phone

(662) 877-5555

NPI assigned

May 21, 2024

Organization subpart

No

Authorized official

Name

Sharon Johnson-Eby, LAC., DCM NPI 1760754931

Title

Acupuncturist, Doctor/ Owner

Phone

(662) 877-4555

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

• Sharon Denice Johnson-Eby, RRT Acupuncturist · Bloomington, MN · NPI 1760754931
  NPD Authorized official ACUPUNCTURIST

National Provider Directory

Locations

Specialties & licenses

Addresses

Other names

• An Medi-Zen Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 21, 2024.

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1104665041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130A PEARMAN ROAD",
            "city": "BOYLE",
            "state": "MS",
            "postal_code": "387309770",
            "telephone_number": "662-877-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 S. BROADWAY STREET",
            "address_2": "SUITE 1",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "38701",
            "telephone_number": "662-877-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AN MEDI-ZEN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON-EBY",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "ACUPUNCTURIST, DOCTOR/ OWNER",
        "authorized_official_telephone_number": "662-877-4555",
        "authorized_official_credential": "LAC., DCM"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "An Medi-Zen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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