NPIMap

Organization Active NPI

Stone Mountain Medicine-Acupuncture

  • Clinic/Center
  • Berkeley, CA
National Provider Identifier
1336676022
Registry record updated May 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
8691 Issued in CA
Legal business name
STONE MOUNTAIN MEDICINE-ACUPUNCTURE
Practice address
1533 Shattuck Ave
Berkeley, CA 94709-1516
Phone
(510) 549-9905
NPI assigned
May 12, 2017
Last updated
May 12, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2017

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

Authorized official

Name
Michael FitzgeraldNPI 1043753593
Title
Licensed Acupuncturist
Phone
(510) 549-9905

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
Clinic/Center 261Q00000X 8691 CA Primary

Addresses

Primary practice location

1533 Shattuck Ave
Berkeley, CA 94709-1516

Mailing address

1533 Shattuck Ave
Berkeley, CA 94709-1516
Phone (510) 549-9905

National Provider Directory

National Provider Directory

Locations

1533 Shattuck Ave
Berkeley, CA 94709
Phone (415) 683-0532

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494547200000",
    "number": "1336676022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 SHATTUCK AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947091516",
            "telephone_number": "510-549-9905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1533 SHATTUCK AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947091516",
            "telephone_number": "510-549-9905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONE MOUNTAIN MEDICINE-ACUPUNCTURE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-12",
        "last_updated": "2017-05-12",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "LICENSED ACUPUNCTURIST",
        "authorized_official_telephone_number": "510-549-9905"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "8691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2017; 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.