Chinese Medical Clinic LLC

Primary specialty

AcupuncturistTaxonomy code 171100000X

Legal business name

CHINESE MEDICAL CLINIC LLC

Practice address

600 Houze Way Suite E-4
Roswell, GA 30076

Phone

(678) 770-7207

Fax

(470) 407-6985

NPI assigned

Dec 27, 2021

Last updated

Dec 27, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jie Wang, L.A.C, ACUPUNCTURISTNPI 1902038243

Title

Owner/Heath Care Provider

Phone

(678) 770-7207

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Jie Wang, ACUPUNCTURIST

  • Acupuncturist
  • Roswell, GA
  • NPI 1902038243
  NPD (past) Authorized official

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

{
    "created_epoch": "1640563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640563200000",
    "number": "1255091674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 HOUZE WAY SUITE E-4",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "30076",
            "telephone_number": "678-770-7207",
            "fax_number": "470-407-6985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HOUZE WAY SUITE E-4",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "30076",
            "telephone_number": "678-770-7207",
            "fax_number": "470-407-6985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHINESE MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-27",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "JIE",
        "authorized_official_title_or_position": "OWNER/HEATH CARE PROVIDER",
        "authorized_official_telephone_number": "678-770-7207",
        "authorized_official_credential": "L.A.C, ACUPUNCTURIST"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INSURANCE",
            "identifier": "52012427",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Roswell, GA
• Providers in Roswell, GA by specialty
• Acupuncturist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; 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.