Individual provider Active NPI

Edward Mitchell O'Brien, L.AC. MMQ

  • Acupuncturist
  • Gettysburg, PA
National Provider Identifier
1245489988
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AK644 Issued in PA
Practice address
2311 Fairfield Rd.
Suite E
Gettysburg, PA 17325
Phone
(717) 586-7044
NPI assigned
Sep 18, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AK644 PA Primary
Acupuncturist 171100000X 400961 MD

Addresses

Primary practice location

2311 Fairfield Rd.
Suite E
Gettysburg, PA 17325

Mailing address

2311 Fairfield Rd.
Suite E
Gettysburg, PA 17325
Phone (717) 586-7044

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
400961MDMDAcupuncturist
AK644PAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221696000000",
    "number": "1245489988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 FAIRFIELD RD.",
            "address_2": "SUITE E",
            "city": "GETTYSBURG",
            "state": "PA",
            "postal_code": "17325",
            "telephone_number": "717-586-7044",
            "fax_number": "717-334-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 FAIRFIELD RD.",
            "address_2": "SUITE E",
            "city": "GETTYSBURG",
            "state": "PA",
            "postal_code": "17325",
            "telephone_number": "717-586-7044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "EDWARD",
        "middle_name": "MITCHELL",
        "name_prefix": "Mr.",
        "credential": "L.AC. MMQ",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-18",
        "last_updated": "2008-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "PA",
            "license": "AK644",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MD",
            "license": "400961",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gettysburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; 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.