Active NPI
Michael Clinton Runyan, AP
- Acupuncturist
- Jacksonville, FL
National Provider Identifier
1154349272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AP 1395
- Practice address
- 4253 Covered Creek CT
Jacksonville, FL 32277-1444 - Phone
- (904) 745-3934
- Fax
- (904) 745-3238
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- 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 | AP 1395 | FL | Primary |
Addresses
Primary practice location
4253 Covered Creek CT
Jacksonville, FL 32277-1444
Mailing address
4253 Covered Creek CT
Jacksonville, FL 32277-1444
Phone (904) 745-1735
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 |
|---|---|---|---|
| AP 1395 | FL | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443657600000",
"number": "1154349272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4253 COVERED CREEK CT",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322771444",
"telephone_number": "904-745-1735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4253 COVERED CREEK CT",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322771444",
"telephone_number": "904-745-3934",
"fax_number": "904-745-3238"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUNYAN",
"first_name": "MICHAEL",
"middle_name": "CLINTON",
"name_prefix": "Mr.",
"credential": "AP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2015-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "FL",
"license": "AP 1395",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.