Individual provider Active NPI

Kyle Thomas, LAC

  • Acupuncturist
  • Brunswick, GA
National Provider Identifier
1295128395
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
530 Issued in GA
Practice address
777 Gloucester St Ste 305
Brunswick, GA 31520-0002
Phone
(912) 574-7053
NPI assigned
Mar 13, 2015
Last updated
Mar 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 174 AK
Acupuncturist 171100000X 530 GA Primary

Addresses

Primary practice location

777 Gloucester St Ste 305
Brunswick, GA 31520-0002

Mailing address

156 Lakes Dr
Brunswick, GA 31523-7888
Phone (907) 209-9875

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
174AKMDAcupuncturist
530GAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1426204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1295128395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 LAKES DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315237888",
            "telephone_number": "907-209-9875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 GLOUCESTER ST STE 305",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315200002",
            "telephone_number": "912-574-7053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KYLE",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-13",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "AK",
            "license": "174",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "GA",
            "license": "530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; 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.