Individual provider Active NPI

Jennifer Lynn McIntosh, L.AC.

  • Acupuncturist
  • Millburn, NJ
National Provider Identifier
1154626547
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
25MZ00074200 Issued in NJ
Practice address
318 Main St Ste 200a
Millburn, NJ 07041-1181
Phone
(973) 544-8381
NPI assigned
Jan 17, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 004301-1 NY
Acupuncturist 171100000X 25MZ00074200 NJ Primary

Addresses

Primary practice location

318 Main St Ste 200a
Millburn, NJ 07041-1181

Mailing address

318 Main St Ste 200a
Millburn, NJ 07041-1181
Phone (732) 718-8652

Other practice location 1

187 Millburn Ave
Millburn, NJ 07041-1847
Phone (973) 467-1466

Other practice location 2

108 Baker St
Maplewood, NJ 07040-2531
Phone (973) 544-8381

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
25MZ00074200NJMDAcupuncturist
004301-1NYMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1295222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1154626547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 MAIN ST STE 200A",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411181",
            "telephone_number": "732-718-8652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 MAIN ST STE 200A",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411181",
            "telephone_number": "973-544-8381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "187 Millburn Ave",
            "address_purpose": "LOCATION",
            "city": "Millburn",
            "state": "NJ",
            "postal_code": "070411847",
            "country_code": "US",
            "telephone_number": "973-467-1466",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "108 Baker St",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "NJ",
            "postal_code": "070402531",
            "country_code": "US",
            "telephone_number": "973-544-8381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-17",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "004301-1",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00074200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millburn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; 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.