Organization Active NPI

Bright Shen Acupuncture

  • Acupuncturist
  • Bloomingdale, IL
National Provider Identifier
1255193876
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
Legal business name
BRIGHT SHEN ACUPUNCTURE
Practice address
142 S Gary Ave Ste 111
Bloomingdale, IL 60108-2226
Phone
(847) 648-7990
NPI assigned
Jan 29, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Authorized official

Name
Mrs. Kinga Van Brunt, LAC.NPI 1326633066
Title
Founder
Phone
(847) 648-7990

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)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X Primary

Addresses

Primary practice location

142 S Gary Ave Ste 111
Bloomingdale, IL 60108-2226

Mailing address

1808 Maryland Dr
Elk Grove Village, IL 60007-2734
Phone (847) 648-7990

Other identifiers 2

IdentifierTypeStateIssuer
15661281OtherILCAQH
19800014OtherILIDFPR

National Provider Directory

National Provider Directory

Locations

142 S Gary Ave
Ste 111
Bloomingdale, IL 60108
Phone (847) 648-7990

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706486400000",
    "number": "1255193876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 MARYLAND DR",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600072734",
            "telephone_number": "847-648-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 S GARY AVE STE 111",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082226",
            "telephone_number": "847-648-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT SHEN ACUPUNCTURE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "VAN BRUNT",
        "authorized_official_first_name": "KINGA",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "847-648-7990",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LAC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15661281",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDFPR",
            "identifier": "19800014",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.