Bodytech Acupuncture

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

317 Issued in NC

Legal business name

BODYTECH ACUPUNCTURE

Practice address

109 Hinton Ave
# 10
Wilmington, NC 28403-4786

Phone

(910) 200-8806

NPI assigned

Feb 24, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Kristain Lee Petersen, L.AC.

Title

Owner

Phone

(910) 200-8806

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Kristian Lee Petersen, L. AC.

  • Acupuncturist
  • Wilmington, NC
  • NPI 1376765479
  NPD (past)

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

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456272000000",
    "number": "1285094953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 HINTON AVE",
            "address_2": "# 10",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034786",
            "telephone_number": "910-200-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 HINTON AVE",
            "address_2": "# 10",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034786",
            "telephone_number": "910-200-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODYTECH ACUPUNCTURE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-24",
        "last_updated": "2016-02-24",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "KRISTAIN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-200-8806",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L.AC."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NC",
            "license": "317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Allen Blumenkehl
• Edward Boris Blyther, LCSW
• Nolan Bodah, D.D.S.
• John Herman Bode, P.A.
• Body Innovations Physical Therapy & Wellness LLC
• Bodytherapy, Inc.
• Deborah Hankins Boedeker, FNP-BC
• Thomas Whiteford Boeker, MD
• Teresa Singletary Boggs, HIS #1198
• Janet Carol Bogus, F-AAA

• Health Service Clinic/Center in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Health Service Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; 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.