Individual provider Active NPI

Nataliya Runtova

  • Acupuncturist
  • Brookfield, WI
National Provider Identifier
1134584030
Registry record updated Dec 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
823-55 Issued in WI
Practice address
333 Bishops Way
Suite 121
Brookfield, WI 53005-6226
Phone
(414) 350-8279
NPI assigned
Dec 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 823-55 WI Primary

Addresses

Primary practice location

333 Bishops Way
Suite 121
Brookfield, WI 53005-6226

Mailing address

3545 E Tesch Ave
Ap 3
Saint Francis, WI 53235-4862
Phone (414) 350-8279

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
823-55WIMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Blooming Buds Medicine Acupuncturist Past Accepting new patients

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": "1450396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450396800000",
    "number": "1134584030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 E TESCH AVE",
            "address_2": "AP 3",
            "city": "SAINT FRANCIS",
            "state": "WI",
            "postal_code": "532354862",
            "telephone_number": "414-350-8279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 BISHOPS WAY",
            "address_2": "SUITE 121",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530056226",
            "telephone_number": "414-350-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNTOVA",
        "first_name": "NATALIYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-18",
        "last_updated": "2015-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WI",
            "license": "823-55",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.

Verify at the official NPI Registry.