Individual provider Active NPI

Michelle Pawley, LAC

  • Acupuncturist
  • Bloomington, IL
National Provider Identifier
1114474822
Registry record updated Sep 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
198001321 Issued in IL
Practice address
1617 E Oakland Ave
Bloomington, IL 61701-5617
Phone
(309) 445-1502
NPI assigned
Sep 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 198001321 IL Primary

Addresses

Primary practice location

1617 E Oakland Ave
Bloomington, IL 61701-5617

Mailing address

1617 E Oakland Ave
Bloomington, IL 61701-5617
Phone (309) 445-1502

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
198001321ILMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1473465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473465600000",
    "number": "1114474822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1617 E OAKLAND AVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617015617",
            "telephone_number": "309-445-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 E OAKLAND AVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617015617",
            "telephone_number": "309-445-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWLEY",
        "first_name": "MICHELLE",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-10",
        "last_updated": "2016-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IL",
            "license": "198001321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2016; 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.