Active NPI
Kelly Jean Sandberg
- Acupuncturist
- Anchorage, AK
National Provider Identifier
1215437702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 45
- Practice address
- 4007 Old Seward Hwy Ste 800
Anchorage, AK 99503-6075 - Phone
- (907) 563-0071
- Fax
- (907) 569-0071
- NPI assigned
- Feb 20, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 45 | AK | Primary |
Addresses
Primary practice location
4007 Old Seward Hwy Ste 800
Anchorage, AK 99503-6075
Mailing address
4007 Old Seward Hwy Ste 800
Anchorage, AK 99503-6075
Phone (907) 563-0071
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 |
|---|---|---|---|
| 45 | AK | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RBS Evolution of Alaska LLC | 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": "1519084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519084800000",
"number": "1215437702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4007 OLD SEWARD HWY STE 800",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995036075",
"telephone_number": "907-563-0071",
"fax_number": "907-569-0071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4007 OLD SEWARD HWY STE 800",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995036075",
"telephone_number": "907-563-0071",
"fax_number": "907-569-0071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDBERG",
"first_name": "KELLY",
"middle_name": "JEAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-20",
"last_updated": "2018-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Acupuncturist",
"state": "AK",
"license": "45",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.