Active NPI
Classical Acupuncture Clinic
- Acupuncturist
- St Augustine, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- Legal business name
- CLASSICAL ACUPUNCTURE CLINIC
- Doing business as
- Classical Acupuncture Clinic
- Practice address
- 260 Paseo Reyes Dr
Saint Augustine, FL 32095-8462 - Phone
- (904) 806-3441
- Fax
- (904) 592-5370
- NPI assigned
- May 20, 2019
- Organization subpart
- Yes
- Parent organization
- TRACY L KOZAK
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tracy L Kozak, LAC
- Title
- Owner
- Phone
- (904) 806-3441
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | Primary |
Addresses
Primary practice location
260 Paseo Reyes Dr
Saint Augustine, FL 32095-8462
Mailing address
260 Paseo Reyes Dr
Saint Augustine, FL 32095-8462
Phone (904) 806-3441
Other names 1
- Classical Acupuncture Clinic
National Provider Directory
National Provider Directory- Part of
- Classical Acupuncture Clinic
Locations
105 Mariner Health Way
Ste 209
Saint Augustine, FL 32086
260 Paseo Reyes Dr
St Augustine, FL 32095
Phone (904) 670-0709
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Acupuncturist
- St Augustine, FL
- NPI 1154355121
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558310400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1599436800000",
"number": "1235796822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "260 PASEO REYES DR",
"city": "SAINT AUGUSTINE",
"state": "FL",
"postal_code": "320958462",
"telephone_number": "904-806-3441",
"fax_number": "904-592-5370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 PASEO REYES DR",
"city": "SAINT AUGUSTINE",
"state": "FL",
"postal_code": "320958462",
"telephone_number": "904-806-3441",
"fax_number": "904-592-5370"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLASSICAL ACUPUNCTURE CLINIC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "TRACY L KOZAK",
"enumeration_date": "2019-05-20",
"last_updated": "2020-09-07",
"certification_date": "2020-09-07",
"status": "A",
"authorized_official_last_name": "KOZAK",
"authorized_official_first_name": "TRACY",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "904-806-3441",
"authorized_official_credential": "LAC"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Acupuncturist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Classical Acupuncture Clinic",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Classical Acupuncture Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in St Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.