Active NPI
Kelly Van Sickell, ACUPUNCTURIST
- Acupuncturist
- Tinton Falls, NJ
National Provider Identifier
1114126133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 25MZ00006000
- Practice address
- 656 Shrewsbury Ave
Suite 103
Tinton Falls, NJ 07701-4964 - Phone
- (732) 842-4198
- Fax
- (732) 842-4112
- NPI assigned
- Jul 11, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 25MZ00006000 | NJ | Primary |
Addresses
Primary practice location
656 Shrewsbury Ave
Suite 103
Tinton Falls, NJ 07701-4964
Mailing address
656 Shrewsbury Ave
Suite 103
Tinton Falls, NJ 07701-4964
Phone (732) 842-4198
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
| License | State | Type | Specialty |
|---|---|---|---|
| 25MZ00006000 | NJ | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443139200000",
"number": "1114126133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "656 SHREWSBURY AVE",
"address_2": "SUITE 103",
"city": "TINTON FALLS",
"state": "NJ",
"postal_code": "077014964",
"telephone_number": "732-842-4198",
"fax_number": "732-842-4112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "656 SHREWSBURY AVE",
"address_2": "SUITE 103",
"city": "TINTON FALLS",
"state": "NJ",
"postal_code": "077014964",
"telephone_number": "732-842-4198",
"fax_number": "732-842-4112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN SICKELL",
"first_name": "KELLY",
"credential": "ACUPUNCTURIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-11",
"last_updated": "2015-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NJ",
"license": "25MZ00006000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tinton Falls, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.