Individual provider Active NPI

Theresa Jung-Sun Min, MSOM, R.AC

  • Acupuncturist
  • Novi, MI
National Provider Identifier
1225432164
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
5401000143 Issued in MI
Practice address
42350 Grand River Ave
Novi, MI 48375-1838
Phone
(248) 697-2942
Fax
(248) 436-6628
NPI assigned
Oct 21, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 5401000143 MI Primary

Addresses

Primary practice location

42350 Grand River Ave
Novi, MI 48375-1838

Mailing address

42350 Grand River Ave
Novi, MI 48375-1838
Phone (248) 697-2942

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
5401000143MIMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Hands Theresa Acupuncturist Current Accepting new patients
Restorative Physical Medicine PLLC CurrentSince Oct 23, 2022 Accepting new patients

Locations

42350 Grand River Ave
Novi, MI 48375
Phone (248) 697-2942

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCJACD

Organizations & group practices 2

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": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1225432164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42350 GRAND RIVER AVE",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751838",
            "telephone_number": "248-697-2942",
            "fax_number": "248-436-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42350 GRAND RIVER AVE",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751838",
            "telephone_number": "248-697-2942",
            "fax_number": "248-436-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIN",
        "first_name": "THERESA",
        "middle_name": "JUNG-SUN",
        "credential": "MSOM, R.AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-21",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MI",
            "license": "5401000143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.