Formless Form Qigong & Acupuncture

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

1588 Issued in MN

Legal business name

FORMLESS FORM QIGONG & ACUPUNCTURE

Practice address

5603 Chicago Ave
Minneapolis, MN 55417-2429

Phone

(612) 708-0753

NPI assigned

Oct 22, 2012

Organization subpart

No

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

Authorized official

Name

Peng Roden Her, LACNPI 1760733885

Title

Owner

Phone

(612) 708-0753

Specialties & licenses 1

Addresses

Practitioners 1

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

• Peng Roden Her, L.AC.

  • Acupuncturist
  • Minneapolis, MN
  • NPI 1760733885
  NPD (past) Authorized official

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

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519862400000",
    "number": "1306199864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5603 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172429",
            "telephone_number": "612-708-0753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5603 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172429",
            "telephone_number": "612-708-0753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORMLESS FORM QIGONG & ACUPUNCTURE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-22",
        "last_updated": "2018-03-01",
        "status": "A",
        "authorized_official_last_name": "HER",
        "authorized_official_first_name": "PENG",
        "authorized_official_middle_name": "RODEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-708-0753",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "1588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Forefront Dermatology, S.C.
• Joanna Forga, RN
• Billie Edward Forisha, PH.D.
• Michael William Forkey, RN, GNP
• Kaila Formanek, LGSW
• Hannah Marcella Forrest, RN
• Meghan Forrest, DIPL.AC, LAC
• Frances Jeanne Forse
• Margaret Forse
• Kristen Suzanne Forseth, NNP-BC

• Acupuncturist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Acupuncturist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; 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.