Jin Fang, ACUPUNCTURIST

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

000333 Issued in NY

Practice address

6605 Pittsford Palmyra Rd
Blackwatch Office Park E-2
Fairport, NY 14450-3407

Phone

(585) 223-7880

NPI assigned

Sep 24, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ancient Acupuncture and Chinese Herbs

  • Acupuncturist
  • Fairport, NY
  • NPI 1174255681
  NPD Authorized official

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1295835718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 STEELE RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144509517",
            "telephone_number": "585-678-9677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6605 PITTSFORD PALMYRA RD",
            "address_2": "BLACKWATCH OFFICE PARK E-2",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503407",
            "telephone_number": "585-223-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANG",
        "first_name": "JIN",
        "name_prefix": "Mrs.",
        "credential": "ACUPUNCTURIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-24",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "000333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACUPUNCTURE",
            "identifier": "000333",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACUPUNCTURE",
            "identifier": "000852",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fairport Physical Therapy, PC
• Fairport Psychiatric Associates
• Fairport Smiles Dentistry, PC
• Fairport SNF LLC
• Fairport Transportation LLC
• Sarah Kidd Farney, PSY.D.
• Shannon Lynn Favalo, PT
• Gia M. Fedrau, RN
• Shana A Feissner, SP. ED. TEACHER
• Elizabeth Anne Fenton

• Acupuncturist in Fairport, NY
• Providers in Fairport, NY by specialty
• Acupuncturist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.